护理团队指导社区协作的连续性护理在妊娠期糖尿病中的应用

Application of continuous nursing under the mode of hospital nursing team guiding community nursing staff in gestational diabetes

目的探讨医院多学科护理团队指导社区护理人员模式下的连续性护理在妊娠期糖尿病孕妇的管理和改善妊娠结局中的作用。方法收集2016年10月~2018年6月期间在我院诊断为妊娠期糖尿病的孕妇,随机分为两组,一组给予常规护理,另一组给予社区连续性护理,对研究对象进行血糖动态随访检测。记录两组患者随访期间随机血糖和空腹血糖的平均值以及两组患者妊娠合并症的发生率和剖宫产率,对上述评价指标进行统计学分析。结果干预组患者相比较对照组患者随访期间随机血糖[干预组(5.6±1.3)mmol/Lvs对照组(6.8±1.7)mmol/L,P=0.021]和空腹血糖[干预组(4.4±1.1)mmol/Lvs对照组(5.1±1.4)mmol/L,P=0.016]水平均值明显下降。GDM患者的妊娠合并症发生率[(干预组(32%)vs对照组(54%),χ^2=4.937,P=0.026]和剖宫产率[干预组(24%)vs对照组(44%),χ^2=4.456,P=0.035]明显下降。结论护理团队社区协作的连续性护理模式可以明显改善患者的血糖管理和控制水平,降低妊娠合并症发生率和剖宫产率。

Objective To explore the role of continuous nursing under the mode of hospital multidisciplinary nursing team guiding community nursing staff in the management of pregnant women with gestational diabetes and the improvement of pregnancy outcomes. Methods Pregnant women who were diagnosed with gestational diabetes in our hospital from October 2016 to June 2018 were randomly divided into two groups. One group was given routine nursing(control group) and the other group was given community continuous nursing(intervention group). Dynamic blood glucose follow-up test was conducted. The mean values of random and fasting blood glucose in the follow-up period, incidence of pregnancy complications and cesarean section rate in the two groups were recorded. Results Patients in the intervention group had significantly lower random blood glucose(5.6±1.3 mmol/L vs 6.8±1.7 mmol/L in the control group, P=0.021) and lower fasting blood glucose(4.4±1.1 mmol/L vs 5.1±1.4 mmol/L in the control group, P=0.016). The incidence of pregnancy complications in GDM patients(32% in the intervention group, 54% in the control group,χ^2=4.937, P=0.026) and cesarean section rate(24% in the intervention group vs 44% in the control group,χ^2=4.456, P=0.035) significantly declined. Conclusion The continuous nursing under the nursing team–community collaboration mode can significantly improve patient's blood glucose management and control levels, reducing the incidence of pregnancy complications and cesarean section rate.