个案管理对妊娠糖尿病患者的影响

The influence of case management on gestational diabetes

目的探讨个案管理对妊娠糖尿病患者的影响。方法 94例妊娠糖尿病患者随机分为观察组、对照组各47例,对照组患者给予常规管理,观察组给予个案管理;比较两组患者孕期管理前后糖尿病相关指标变化情况及孕妇妊娠结局及新生儿结局。结果对照组显性糖尿病的发生率为25.53%,观察组为4.26%;经管理后,观察组患者空腹血糖、餐后两小时血糖、糖化血红蛋白等糖尿病相关指标均优于对照组,差异均有统计学意义(P<0.05);观察组患者妊娠高血压症、羊水过多、剖宫产、早产、产后感染发生率均显著低于对照组,围产期新生儿结局显著优于对照组(均P<0.05)。结论对妊娠糖尿病患者采用个案管理方案,能显著控制患者血糖水平,对妊娠结局产生积极作用。

Objective To understand the influence of case management on gestational diabetes. Method Firstly,94 cases of gestational diabetes were randomly divided an experimental group（ n = 47） and a control group（ n = 47）. The control group were treated with conventional management while the experimental were administered with case management. The incidence of overt diabetes,the changes to diabetes related indicators,the effects of different management outcomes for pregnant women and neonatal outcomes of pregnancy of the two groups were then compared. Findings The overt diabetes incidence rate of the control group was 25. 53%,which was significantly higher than that（ 4. 26%） of the experimental group. The difference was statistically significant（ P〈0. 05）. After management,the level of fasting blood glucose,the level of postprandial（ two hours） blood glucose,and glycated hemoglobin diabetes-related indicators as observed in the experimental group were better those in the control group（ P〈0. 05）. Gestational hypertension,polyhydramnios,infection cesarean section,premature delivery and postpartum in the experimental group were significantly lower than those of the control group（ P〈0. 05）. Perinatal neonatal outcomes of patients in the experimental group was significantly better than those of the control group（ P〈0. 05）. Conclusion For patients with gestational diabetes case management can significantly control the level of blood sugar and hence imposes a positive effect on pregnancy outcome.