个性化营养干预配合孕期教育对妊娠期糖尿病患者血糖控制及妊娠结局的影响

Effect of individualized nutrition intervention and pregnancy education on blood glucose control and pregnancy outcomes in patients with gestational diabetes mellitus

目的探讨个性化营养干预配合孕期教育对妊娠期糖尿病患者血糖控制及妊娠结局的影响。方法选择2014年8月至2016年8月在汉川市人民医院治疗的妊娠期糖尿病患者100例,采用随机数字表法将其分为两组,对照组50例实施个性化营养干预,观察组50例在对照组基础上增加基于微信平台的孕期教育。观察两组患者依从性、血糖控制效果及分娩方式。结果干预后两组患者依从性量表各维度及总表得分均有明显提升(P <0. 05),观察组提升幅度更为明显(P <0. 05)。干预前两组患者空腹血糖与餐后2 h血糖比较差异无统计学意义(P> 0. 05);干预后两组患者空腹血糖与餐后2 h血糖均明显下降(P <0. 05),且观察组低于对照组(P <0. 05)。对照组难产率14. 0%(7/50)明显高于观察组的2. 0%(1/50)(P <0. 05)。结论个性化营养干预配合基于微信平台的孕期教育相对于单纯个性化营养干预可明显提升妊娠期糖尿病患者的依从性,降低患者空腹及餐后2 h血糖,降低难产率。

Objective To explore the effect of personalized nutrition intervention and pregnancy education on glycemie control and pregnancy outcomes in patients with gestational diabetes mellitus. Methods 100 women with gestational diabetes mellitus treated in Hanchuan People＇s Hospital from August 2014 to August 2016 were selected. They were divided into two groups according to the random number table. 50 patients in the control group were treated with personalized nutrition intervention, and others in the observation group were educated by WeChat platform on the basis of the control group. Observed the compliance, effect of blood sugar control and delivery mode of two groups. Results After intervention, each dimension and total score of comphance scale were significantly improved （ P 〈 0. 05 ）, but the improvement rate of the observation group was more obvious （ P 〈 0. 05 ）. The fasting blood glucose and postprandial 2 h blood glucose of two groups had no significant difference before intervention（ P 〉 0.05 ） ,and two indexes decreased significantly after intervention, the observation group lower than the control group （ P 〈 0.05 ）. The control group had a dystocia rate of 14. 0 % （7/50）, which was significantly higher than that of the observation group （2.0 % , 1/50） ,the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Individualized nutrition intervention combined with WeChat platform - based pregnancy education can improve the compliance of gestational diabetes patients significantly, reduce the fasting and postprandial 2 h blood glucose, reduce the dystocia rate.