助产护理模式对妊娠期糖尿病产妇分娩质量的效果观察

Observation of effect by midwifery nursing pattern for quality of delivery in puerpera with gestational diabetes mellitus

目的探讨助产护理模式在临床应用中对妊娠期糖尿病产妇分娩质量的影响。方法 80例妊娠期糖尿病产妇,随机分为实验组和对照组,各40例。对照组产妇采取常规的护理方式,辅以妇产科标准的接生方法进行产期护理。实验组产妇采用全程助产护理模式进行护理。观察并比较两组产妇血糖控制情况、分娩质量以及新生儿质量。结果首次测量时,两组产妇空腹血糖、餐后2 h血糖以及糖化血红蛋白水平比较差异无统计学意义(P>0.05);护理后,实验组产妇空腹血糖、餐后2 h血糖以及糖化血红蛋白水平均低于对照组,差异具有统计学意义(P<0.05)。实验组产妇分娩时疼痛视觉模拟评分法(VAS)评分为(6.42±0.78)分、总产程为(467.12±41.21)min、产后出血量为(114.21±8.21)ml,均优于对照组产妇的(8.42±1.08)分、(607.12±40.11)min、(184.21±12.21)ml,差异具有统计学意义(P<0.05)。实验组新生儿质量优于对照组,差异具有统计学意义(P<0.05)。结论在分娩期施行较为全面的全程助产护理模式及进行精细化护理将有助于妊娠期糖尿病产妇控制血糖情况,降低分娩风险,提高分娩质量,在临床应用上具有广泛推广的实践价值。

Objective To investigate influence by clinical application of midwifery nursing pattern on quality of delivery in puerpera with gestational diabetes mellitus. Methods A total of 80 puerpera with gestational diabetes mellitus were randomly divided into experimental group and control group, with 40 cases in each group. The control group received conventional nursing measures, with assistant perinatal nursing based on gynecological delivery standard. The experimental group received whole midwifery nursing pattern. Observation and comparison were made on blood glucose control status, quality of delivery and quality of newborn between the two groups. Results At the first measurement, there was no statistically significant difference of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin levels between the two groups（P〉0.05）. After nursing, the experimental group had all lower fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin levels than the control group, and the difference had statistical significance（P〈0.05）. The experimental group had visual analogue scale（VAS） score during delivery as（6.42±0.78） points, total stage of labor as（467.12±41.21） min, and postpartum bleeding volume as（114.21±8.21） ml, which were all better than（8.42±1.08） points,（607.12±40.11） min and（184.21±12.21） ml in the control group. Their difference had statistical significance（P〈0.05）. The experimental group had better quality of newborn than the control group, and the difference had statistical significance（P〈0.05）. Conclusion Implement comprehensive whole midwifery nursing pattern and detailed nursing during delivery is helpful to control blood glucose in puerpera with gestational diabetes mellitus, reduce delivery risk and improve quality of delivery. This method contains practical value for wide promotion in clinical application.