产后管理对妊娠期糖尿病患者血糖控制结局的影响

Effect of postpartum management on glycemic controlling of gestational diabetes mellitus patients

目的探讨产后管理对妊娠期糖尿病患者血糖控制结局的影响。方法随机抽取2014年3月-2016年3月南方医科大学附属深圳市妇幼保健院收治的386例妊娠期糖尿病(GDM)患者作为研究对象,以随机数字表作为分组原则将其分为研究组与对照组,每组各193例。对照组患者接受常规出院指导,研究组在此基础上实施产后管理干预。观察对比两组产后不同时间段(产后3 d、42 d、90 d)血糖水平变化,以及干预前与干预后3个月时对疾病知识的掌握程度。结果研究组产后30 d及90 d时空腹血糖、餐后2 h血糖及糖化血红蛋白均低于对照组,差异有统计学意义(P<0.05)。研究组干预后GDM健康知识调查问卷评分显著高于对照组与干预前(P<0.05)。研究组产后3个月时体质量的降低明显低于对照组,差异有统计学意义(P<0.05)。结论产后管理能够有效改善GDM患者产后的血糖控制结局,适于临床应用与推广。

Objective To explore the effect of postpartum management on glycemic controlling of gestational diabetes mellitus patients. Methods During March 2014 to March 2016, 386 gestational diabetes mellitus （GDM） patients who were cured in Shenzhen maternal and child health care hospital were selected randomly as subjects, and they were divided into two groups according to the random number table, each group with 193 cases. The patients in control group were received routine discharge guidance; the patients in observation group were applied postpartum management basing on the routine discharge guidance. The glycemic level was compared after postpartum 3d, 42d and 90d between the two groups, and compared the disease knowledge of the two groups before and after postpartum 3 month. Result Compared with control group, research group had lower level in fasting blood-glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin after postpartum 30d and 90d, and the differences were statistically significant （P 〈 O. 05 ）. After intervention, research group had higher score of GDM health knowledge than control and before the intervention （P 〈0.05）. After postpartum 3 month, research group had lower BMI reduce than that in control group, and the difference was statistically significant （P 〈 0.05 ）. Conclusion Postpartum management can improve postpartum glycemic controlling of GDM patients, and this method is suitable for clinical application and generalize.