健康教育及饮食护理对妊娠期糖尿病孕妇妊娠结局的影响

Impact of health education and dietary care on pregnancy outcomes in pregnant women with gestational diabetes mellitus

目的探讨健康教育及饮食护理对妊娠期糖尿病(GDM)孕妇妊娠结局的影响。方法选取2016年2月~2017年6月我院收治的90例GDM孕妇作为研究对象,按照随机数字表法分为对照组和观察组,每组各45例。对照组采用常规的护理方案,观察组在对照组基础上给予健康教育及饮食护理。比较两组护理服务总满意度;GDM疾病知识掌握度、治疗依从性、遵医饮食依从性;干预前后孕妇血糖监测指标空腹血糖(FBG)、餐后2 h血糖、(2 h BG)糖化血红蛋白(GHb);妊娠不良事件发生率。结果观察组护理服务的满意度高于对照组,差异有统计学意义(P<0.05);观察组GDM疾病知识掌握度、治疗依从性、遵医饮食依从性高于对照组,差异均有统计学意义(P<0.05);干预前两组血糖监测指标FBG、2 h BG、GHb比较,差异无统计学意义(P>0.05);干预后观察组FBG、2 h BG、GHb低于对照组,差异均有统计学意义(P<0.05)。观察组妊娠不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论健康教育及饮食护理对GDM孕妇妊娠结局有积极的影响,可提升孕妇对疾病的认知,并自觉提高遵医性和合理饮食行为,有效控制血糖,改善妊娠结局,孕妇对护理服务总满意度高,值得推广。

Objective To investigate the effect of health education and dietary care on pregnancy outcomes in pregnant women with gestational diabetes mellitus（GDM）. Methods A total of 90 pregnant women with GDM from February2016 to June 2017 were enrolled in our hospital. They were equally divided into two groups using a random number table method, 45 cases in each group. In control group, routine care was used, while in observation group, health education and dietary care were added on the basis of the control group. Satisfaction with nursing services, mastery of DM knowledge during pregnancy, treatment compliance, compliance with dietary advice in the two groups were compared.The blood glucose monitoring indicators in these participants including fasting blood glucose（FBG）, postprandial 2-hour blood glucose（2 h BG）, and glycosylated hemoglobin（GHb） before and after intervention were also compared. Besides,the incidence of adverse gestational events was compared. Results The satisfaction by pregnant women with GDM in the observation group was higher than that of the control group（P〈0.05）. The mastery of GDM knowledge, treatment compliance, and compliance with dietary advice were all higher in the observation group than in the control group with statistical significance（P〈0.05）. Before intervention, there was no significant difference in FBG, 2 h BG, or GHb between the two groups（P〉0.05）. After nursing intervention, these three indicators were, lower in the observation group compared with those in the control group with statistical significance（P〈0.05）. The incidence of adverse pregnancy events in the observation group was lower than that in the control group with a significant difference（P〈0.05）. Conclusion Health education and dietary nursing have positive impacts on the pregnancy outcomes in pregnant women with GDM. They both can enhance the awareness of pregnant women on DM, willingly increase the treatment compliance and reasonable dietary behavior, effectively control blood glucose, and improve pregnancy outcomes with high satisfaction on nursing services by pregnant women, which is worthy of promotion.