妊娠糖尿病患者自我管理行为对血糖控制及妊娠结局的影响

Effect of self-management behaviors on blood glucose control and pregnancy outcomes among patients with gestational diabetes mellitus

目的探讨妊娠糖尿病(GDM)患者自我管理行为对血糖控制及妊娠结局的影响效果。方法我院于2017年1—12月应用"妊娠糖尿病自我管理行为"量表对120例GDM患者进行调查,调查结果分为自我管理行为低水平组42例、中等水平组38例及高等水平组40例,比较各组血糖控制情况及妊娠结局情况。结果 GDM自我管理低水平组空腹血糖(FBG)、餐后2 h血糖(2hFBG)、糖化血糖(HAblc)、体质量(BMI)均高于自我管理中等水平及高等水平组(P<0.05),且中等水平组FBG,2hFBG,HAblc,BMI高于高等水平组(P<0.05)。自护能力低水平组饮食、运动、用药、自我血糖监测、情绪管理等依从性低于中等及高等水平组(P<0.05)。自护能力低水平组巨大儿、胎儿窘迫、新生儿低血糖、产妇产后出血等不良妊娠结局发生率明显高于中等及高等水平组(P<0.05)。结论 GDM患者自我管理行为与血糖控制及体重控制有密切的关系,提高GDM患者自我管理行为有助于提高患者治疗依从性,降低不良妊娠结局的发生。

Objective To investigate the effect of self-management behaviors on blood glucose control and pregnancy outcomes among patients with gestational diabetes mellitus（ GDM）. Methods To investigate 120 cases of GDM patients in our hospital from January 2017 to December 2017 by using the＂self-management behaviors of gestational diabetes mellitus＂scale. The survey results were divided into 42 cases with low self-management behavior,38 cases with medium level,and 40 cases with high level. The blood glucose control and pregnancy outcomes in each group were compared. Results The levels of fasting blood glucose（ FBG）,postprandial 2 hours blood glucose（ 2 hFBG）,HAblc,and body mass index（ BMI） in the low-level self-management group of GDM were higher than those in the middle and high self-management groups（ P〈0. 05）. The FBG,2 h FBG,HAblc,and BMI in the middle level group were higher than that in the high level group（ P〈0. 05）. The low-level self-care ability group was lower than the medium and high-level groups in compliance of diet,exercise,medication,self-glucose monitoring,and emotional management（ P〈0. 05）. The incidence of adverse pregnancy outcomes such as macrosomia,low fetal distress,neonatal hypoglycemia,and postpartum hemorrhage was significantly higher in the low-level self-care group than in the medium and high-level groups（ P〈0. 05）. Conclusion The self-management behavior of GDM patients is closely related to glycemic control and weight control. Therefore,improving the self-management behavior of GDM patients can improve the compliance of patients and reduce the occurrence of adverse pregnancy outcomes.