妊娠期糖尿病孕妇产时护理干预

Delivery nursing intervention of gestational diabetes mellitus patients

目的：探讨良好产时护理对妊娠期糖尿病（ GDM）产妇阴道分娩安全性的影响。方法采用回顾性分析2012年10月—2013年10月首都医科大学附属北京妇产医院经阴道分娩的178例GDM产妇作为观察组,同期选择阴道分娩的178例非GDM产妇作为对照组。对观察组产妇实施良好的产时护理干预。比较两组之间产程时间、会阴侧切情况、产钳助娩情况、宫颈裂伤情况及产后出血情况,采用新生儿窒息评估分析GDM产妇阴道分娩的安全性。结果观察组产妇第一产程、潜伏期、活跃期时间分别为（9.82±1.14）,（7.35±1.25）,（2.47±0.40）h,第二产程、第三产程时间分别为（42.36±5.56）,（14.31±3.59）min,与对照组比较,差异无统计学意义（t值分别为2.19,2.22,2.64,2.36,1.97；P〉0.05）。观察组与对照组产妇会阴侧切情况、产钳助娩情况、宫颈裂伤情况、产后出血情况进行比较,差异无统计学意义（χ^2值分别为0.25,0.21,0.84,0.41,0.35；P〉0.05）。结论在良好的护理干预下GDM产妇自然分娩是安全的,应该鼓励无明显阴道分娩禁忌的GDM产妇选择自然分娩。

Objective To investigate the effects of nursing intervention on delivery outcomes of gestational diabetes mellitus （ GDM） patients. Methods A total of 178 GDM patients volunteered for vaginal delivery were set as observation group （ favorable nursing intervention） and 178 non-GDM parturients （ vaginal delivery） were as control group （ vaginal delivery） from October 2012 to October 2013. The length of labor, status of episiotomy, status of forcepsdelivery, status of cervix laceration and postpartum hemorrhage were compared, and the safety of GDM patients （ vaginal delivery） was assessed by neonatal asphyxia assessment. Results In the observation group, the first stage length of labor, incubation period and active phase were （9.82 ±1.14）, （7.35 ±1.25）, （2. 47 ± 0. 40）h, the second and third stage of labor length （42. 36 ± 5. 56）, （14. 31 ± 3. 59） min, which all had no statistical difference compared with those of thecontrol group （t=2. 19, 2. 22, 2. 64, 2. 36, 1. 97;P〉0. 05）. The status of episiotomy, status of forcepsdelivery, status of cervix laceration and postpartum hemorrhage had statistical significance between two groups （χ^2 =0. 25, 0. 21, 0. 84, 0. 41, 0. 35;P〉0. 05）. Conclusions Under favorable nursing intervention, the GDM patients are safe to deliver nature, so it should be encouraged GDM patients select this kind of method if they do no have contraindication.