膳食标准餐管理对妊娠期糖尿病患者的影响

Effect of dietary energy standard meal management on patients with gestational diabetes mellitus

目的观察固定膳食能量标准餐管理对妊娠期糖尿病（GDM）患者血糖、相关知识掌握程度及母婴预后的影响。方法将纳入研究的106例妊娠24～35周的GDM患者抽签分为观察组（56例）和对照组（50例）。对照组给予常规运动、饮食指导方案，观察组除运动指导外给予固定膳食能量标准餐管理方案，干预4周后比较两组血糖及GDM相关知识的掌握情况，并观察分娩后两组母婴结局的差异。结果干预4周后，观察组空腹血糖、餐后2h血糖及睡前血糖均低于对照组，比较有统计学差异（t值分别为4．326、5．356、4．242，P〈0．05）。观察组GDM相关知识掌握从血糖检测方法、生活方式对血糖的影响、GDM的高危因素、GDM对母婴的危害、药物控制的知识知晓程度、低血糖反应的认识及预防处理方法6个方面均高于对照组，两组比较差异均有统计学意义（t值分别为7．453、12．455、14．510、15．503、13．456、16．512，P〈0．05）。分娩后，观察组孕产妇、新生儿结局不良发生总人数均显著低于对照组，两组比较有统计学差异（x^2值分别为4．733、3．912，均P〈0．05），其中观察组胎膜早破、巨大儿、宫内窘迫／生后窒息均显著低于对照组（，值分别为5．456、4．463、5．013，P〈0．05）。结论固定膳食能量标准餐管理有助于GDM患者控制血糖及提高GDM相关知识的掌握程度，从而对母婴结局的改善有积极意义。

Objective To observe the effect of fixed dietary energy standard meal management on blood glucose, related knowledge awareness, maternal and infant prognosis of patients with gestational diabetes mellitus （GDM）. Methods A total of 106 GDM patients of 24 to 35 weeks of pregnancy were randomly divided into observation group （56 cases） and control group （50 cases）. The control group was given routine guidance on exercise and diet, while the observation group was provided with fixed dietary energy standard meal management additionally. Blood glucose and GDM related knowledge were compared between two groups after 4 weeks, and the difference in maternal and neonatal outcomes was observed. Results Compared with the control group, fasting blood glucose, postprandial 2h blood glucose, bedtime blood glucose of the observation group were lower after 4 weeks, and the differences were significant （ t value was 4. 326, 5. 356 and 4. 242, respectively, all P 〈 0.05 ）. The observation group had higher awareness of GDM knowledge than the control group in the aspects of blood glucose detection method, influence of life style on blood glucose, high risk factors of GDM, harm of GDM to mother and infant, awareness of the knowledge about drug control, and the recognition of prevention and treatment of low blood sugar, and the differences were significant （t value was 7. 453, 12. 455, 14. 510, 15. 503, 13. 456 and 16. 512, respectively, all P 〈 0.05）. After delivery, the number of cases with adverse outcomes were less in the observation group than in the control group with statistical significance （x^2 value was 4. 733 and 3. 912, respectively, both P 〈 0.05 ）. The incidences of premature rupture of membranes, macrosomia, intrauterine distress/asphyxia after birth of the observation group were lower （X2 value was 5. 456, 4. 463 and 5. 013, respectively, all P 〈 0.05 ）. Conclusion The fixed dietary energy standard meal management can help GDM patients to control blood glucose and improve GDM related knowledge, thus it is useful in improving maternal and infant outcomes.