综合护理措施在孕前超重肥胖孕妇妊娠期糖尿病预防中的临床效果分析

Analysis of Clinical Effect of Comprehensive Nursing Measures on Prevention of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women before Pregnancy

目的探讨综合护理措施对孕前超重肥胖孕妇妊娠期糖尿病预防效果。方法选取我院(2018年1月至2019年6月)收治的96例孕前超重肥胖孕妇,根据不同护理分为2组,对照组(n=48)接受常规护理,观察组(n=48)接受常规护理,对比两组孕妇不同孕期空腹血糖、妊娠糖尿病发生率、体质量、BMI、体质量增长合格率、剖宫产率和新生情况(巨大儿、新生儿体质量)。结果观察组孕8~12周、孕13~28周、孕29~40周的空腹血糖分别为(4.57±0.21)、(4.52±0.41)、(4.44±0.37)mmol/L、妊娠糖尿病11例(22.92%);对照组分别为(4.59±0.30)、(4.82±0.39)、(4.84±0.36)、19例(47.50%)。两组孕妇孕8~12周空腹血糖对比无差异(P>0.05);两组孕妇孕13~28周、29~40周空腹血糖以及妊娠糖尿病发生率对比差异明显(P<0.05)。两组孕妇孕12周体质量和BMI对比无差异(P>0.05);观察组孕妇孕28周的体质量和BMI分别为(74.4±9.3)kg、(30.5±2.2)kg/m^2,对照组分别为(80.2±10.1)kg、(32.3±2.4)kg/m^2;分娩时候观察组分别为(77.0±10.1)kg、(31.5±2.4)kg/m^2,对照组分别为(88.1±10.4)kg、(35.4±2.3)kg/m^2,对比差异明显(t=2.9268、3.8304、5.3047、8.1284,P<0.05)。观察组孕妇体质量增长合格率29(60.42%),对照组为20(41.67%),两组孕妇体质量增长合格率对比差异明显(χ^2=7.0343,P<0.05)。观察组剖宫产率21(43.75%)、巨大儿5(10.42%)、新生儿体质量(3466.91±332.21)g,对照组分别为29(60.42%)、11(22.92%)、(3879.93±346.14)g,两组孕妇剖宫产率和巨大儿、新生儿体质量对比差异明显(χ^2=5.5675、5.6241,t=7.9643,P<0.05)。结论综合护理控制了体质量,避免了妊娠期糖尿病,降低了剖宫产率,并改善了新生儿结局。

Objective To explore the preventive effect of comprehensive nursing measures on gestational diabetes mellitus of overweight and obese pregnant women before pregnancy.Methods:96 overweight and obese pregnant women in our hospital from January 2018 to June 2019 were divided into two groups according to different nursing.The control group(n=48)received routine nursing,and the observation group(n=48)received routine nursing.The fasting blood glucose,the incidence of gestational diabetes,weight,BMI,the qualifi ed rate of weight growth,the rate of cesarean section and the situation of newborn(huge)were compared between the two groups Weight of infants and newborns).Results:the fasting blood glucose of the observation group was(4.57±0.21),(4.52±0.41),(4.44±0.37)mmol/L,11 cases of gestational diabetes mellitus(22.92%),and that of the control group was(4.59±0.30),(4.82±0.39),(4.84±0.36),19 cases(47.50%).There was no difference in fasting blood glucose between the two groups(P>0.05);there was signifi cant difference in fasting blood glucose and gestational diabetes incidence between the two groups(P<0.05).There was no signifi cant difference in body weight and BMI between the two groups(P>0.05);the body weight and BMI of the observation group were(74.4±9.3)kg and(30.5±2.2)kg/m^2,respectively,and those of the control group were(80.2±10.1)kg and(32.3±2.4)kg/m^2;those of the observation group were(77.0±10.1)kg and(31.5±2.4)kg/m2 respectively,while those of the control group were(88.1±10.4)kg and(35.4±2.3)kg/m^2.The difference was signifi cant(t=2.9268,3.8304,5.3047,8.1284,P<0.05).The qualifi ed rate of pregnant women's weight growth was 29(60.42%)in the observation group and 20(41.67%)in the control group.There was a signifi cant difference between the two groups(χ^2=7.0343,P<0.05).The cesarean section rate was 21(43.75%),5(10.42%)in the observation group,(3466.91±332.21)g in the newborn,29(60.42%),11(22.92%)and(3879.93±346.14)(g in the control group,respectively.There were signifi cant differences between the two groups(χ^2=5.5675,5.6241,t=7.9643,P<0.05).Conclusion:comprehensive nursing can control body weight,avoid gestational diabetes,reduce the rate of cesarean section and improve the outcome of newborn.