个性化营养指导联合孕期教育在妊娠期糖尿病患者中的应用分析

Practical analysis of individualized nutrition guidance combined with pregnancy education in patients with gestational diabetes mellitus

目的探讨个性化营养指导联合孕期教育在妊娠期糖尿病患者中的应用效果。方法 118例妊娠期糖尿病患者,以随机数字表法分为对照组及研究组,每组59例。对照组患者接受个性化营养指导,研究组患者在对照组基础上实施孕期教育。对比两组患者干预前后的血糖(空腹血糖、餐后2 h血糖与糖化血红蛋白)水平、分娩方式(剖宫产与阴道分娩)与妊娠结局(早产、产后出血、巨大儿、新生儿窒息)。结果干预后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平分别为(5.2±0.3)mmol/L、(6.8±1.0)mmol/L、(6.6±0.2)%,低于对照组的(5.9±0.2)mmol/L、(7.5±1.2)mmol/L、(7.4±0.3)%,差异有统计学意义(P<0.05)。研究组剖宫产率低于对照组,阴道分娩率高于对照组,差异有统计学意义(P<0.05)。研究组早产与巨大儿的发生率分别为3.39%、1.69%,低于对照组的15.25%、11.86%,差异有统计学意义(P<0.05);两组产后出血与新生儿窒息发生率对比差异无统计学意义(P>0.05)。结论个性化营养指导联合孕期教育在妊娠期糖尿病患者中具有显著的应用效果,能够有效改善患者的血糖水平,降低剖宫产率,保障妊娠结局,适于临床推广应用。

Objective To discuss the practical effect of individualized nutrition guidance combined with pregnancy education in patients with gestational diabetes mellitus.Methods A total of 118 patients with gestational diabetes mellitus were divided into control group and research group according to random numerical table,with 59 cases in each group.The control group received individualized nutrition guidance,and the research group received pregnancy education based on the control group.The blood glucose(fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin)before and after intervention,delivery modes(cesarean section and vaginal delivery)and pregnancy outcome(premature delivery,postpartum hemorrhage,macrosomia,neonatal asphyxia)were compared between the two groups.Results After intervention,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of the research group were(5.2±0.3)mmol/L,(6.8±1.0)mmol/L and(6.6±0.2)%of the research group were lower than(5.9±0.2)mmol/L,(7.5±1.2)mmol/L and(7.4±0.3)%of the control group,and the difference was statistically significant(P<0.05).The cesarean section rate of the research group was lower than that of the control group,and the vaginal delivery rate was higher than that of the control group.All the difference was statistically significant(P<0.05).The incidence of premature delivery and macrosomia of the research group were 3.39%and 1.69%of the research group were lower than 15.25%and 11.86%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of postpartum hemorrhage and neonatal asphyxia between the two groups(P>0.05).Conclusion Combination of individualized nutrition guidance and pregnancy education shows remarkable practical effect of patients with gestational diabetes mellitus,which can effectively improve the blood glucose level,reduce cesarean section rate,ensure pregnancy outcome.It is suitable for clinical promotion and application.