跨理论模型的饮食干预对妊娠糖尿病病人血糖控制及妊娠结局的影响

Effect of dietary intervention based on cross-theoretical model on glycemic control and pregnancy outcome in patients with gestational diabetes

[目的]探讨跨理论模型的饮食干预对妊娠糖尿病病人血糖控制及妊娠结局的影响。[方法]选取妊娠糖尿病(GDM)病人110例,根据随机数字表法将病人分为观察组及对照组各55例,对照组行常规饮食指导,观察组基于跨理论模型实施饮食干预,比较两组干预前后饮食知识行为、血糖控制效果及妊娠结局情况。[结果]观察组干预后饮食知识、饮食行为评分较对照组显著升高(P<0.05)。观察组干预后空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)水平低于对照组(P<0.05)。观察组剖宫产率、产后出血率、胎膜早破、巨大儿、宫内窒息发生率显著低于对照组(P<0.05),而血糖控制有效率高于对照组(P<0.05)。[结论]基于跨理念模型的饮食干预能有效控制GDM饮食知识及行为,有利于病人血糖控制,改善母婴妊娠结局。

Objective:To probe into the effect of the dietary intervention based on the cross-theoretical model on glycemic control and pregnancy outcome in patients with gestational diabetes.Methods:A total of 110 patients with gestational diabetes mellitus (GDM) were enrolled and divided into the observation group and control group according to the random number table method,55 cases in each group.The patients in control group received routine dietary guidance.The patients in observation group received dietary intervention based on the cross-theoretical model.Dietary knowledge,blood glucose control effects,and pregnancy outcomes before and after intervention were compared between the two groups.Results:Dietary knowledge and dietary behavior of patients in observation group were significantly higher than those in control group ( P <0.05).The levels of fasting blood glucose (FBG),postprandial 2 h blood glucose (2 hPBG) and glycosylated hemoglobin (HbA1C) in observation group were significantly lower than those in control group ( P <0.05).The cesarean section rate,postpartum hemorrhage rate,incidence of premature rupture of membranes,macrosomia and intrauterine asphyxia in observation group were significantly lower than those in control group ( P <0.05),and the effective rate of glycemic control was higher than that in control group ( P <0.05).Conclusions:Dietary intervention based on the cross- theoretical model could effectively control dietary knowledge and behavior of patients with GDM,which was beneficial to patients' blood sugar control and improve maternal and fetal pregnancy outcomes.