自我管理对妊娠期糖尿病患者的影响

Effect of self-management on patients with gestational diabetes mellitus

目的探讨自我管理对妊娠糖尿病患者的影响。方法选取我院2015年1月至2017年12月妇产科接诊的96例妊娠期糖尿病患者作为研究对象,采用数字随机法将其分为对照组46例和研究组50例,对照组给予常规护理教育,研究组实施自我管理干预,比较两组患者干预前后2 h血糖(2 h FG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)水平、自我护理能力、健康行为及妊娠结局。结果经教育干预后,两组患者2hFG,FBG及Hb Alc水平明显优于干预前,干预后两组患者各项水平指数比较差异有统计学意义(P <0. 05);两组患者干预后自我护理能力得到提高,各项指数比较差异有统计学意义(P <0. 05);研究组与对照组健康行为指数明显优于干预前,干预后各项评估指数比较差异有统计学意义(P <0. 05);经干预后研究组患者早产、剖宫产、前置胎盘及胎盘早剥发生率明显低于对照组(P <0. 05)。结论对妊娠期糖尿病患者实施自我管理干预,可有效稳定血糖及HbAlc水平变化,增强患者自我护理能力及健康行为,改善妊娠不良结局,临床可进一步拓展运用。

Objective To investigate the effect of the self-management on patients with gestational diabetes mellitus （GDM）. Methods To compared the levels of 2h fasting glucose （2hFG）, fasting blood glucose （FBG） and glycated hemoglobin（HbAlc）, self-care ability, health behavior, and pregnancy outcome, 96 cases of GDM patients treated in our obstetrics and gynecology department from January 2015 to December 2017 were observed, and divided into control group of 46 members and study group of 50 members by means of random number table method. The control group adopted the routine nursing education, while the study group adopted the self-management intervention. Results The levels of 2hFG, FBG and HbAlc of the two groups after educational intervention were apparently better than that before intervention, and the difference of indexes from respective level after intervention between the two groups was statistically mattered（ P 〈0.05）. The self-care ability of the two groups after intervention was greatly improved, and with which the difference of respective index statistically significant（ P 〈0.05）. The health behavior index of the study group and control group after intervention was evidently better than that before intervention, and the difference of respective evaluating index after intervention had statistical significance（ P 〈0.05）. The incidence of premature delivery, cesarean section, placenta previa and placental abruption after intervention was significantly lower in the study group than that in the control group（ P 〈0.05）. Conclusion The application of self-management intervention on GDM patients could effectively stabilize blood glucose and HbAlc levels, enhance self-care ability and health behavior, and improve adverse pregnancy outcomes. It＇s a highly appreciated intervention worth clinical popularization