DOHaD理念导向的膳食护理在妊娠糖尿病患者中的应用价值

Application value of DOHaD concept oriented dietary nursing in gestational diabetes mellitus patients

目的探讨健康与疾病发育起源(DOHaD)理念导向的膳食护理在妊娠糖尿病(GDM)患者中的应用效果。方法将陆军军医大学第二附属医院2020年1月至2021年5月收治的GDM患者103例采用随机数字表法将其分为观察组(52例)和对照组(51例)。对照组采用常规饮食护理,观察组采用DOHaD理念导向的膳食护理。两组均从入院时开始接受护理干预,直至分娩。比较两组干预前后血糖控制效果[空腹血糖(FPG)、餐后2 h血糖(2hPG)]、自护能力[自护能力测定量表(ESCA)]、不良妊娠结局发生率、饮食依从性及体重指数(BMI)增加幅度。结果干预后,两组FPG、2hPG均低于同组干预前,且观察组低于对照组,差异有统计学意义(P<0.05);两组ESCA评分均高于同组干预前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组不良妊娠结局发生率、BMI增加幅度均低于对照组,差异有统计学意义(P<0.05);观察组饮食依从率高于对照组,差异有统计学意义(P<0.05)。结论DOHaD理念导向的膳食护理可帮助GDM患者控制体重,降低血糖,改善其不良妊娠结局,增强患者自护能力,同时还能提升患者饮食依从性。

Objective To explore the effect of health care and disease development origin(DOHaD)concept oriented dietary nursing in patients with gestational diabetes mellitus(GDM).Methods A total of 103 patients with GDM treated in the Second Affiliated Hospital of the Army Medical University from January 2020 to may 2021.They were divided into observation group(52 cases)and control group(51 cases)according to the random number table method.The control group was treated with routine dietary nursing,and the observation group was treated with DOHaD concept oriented dietary nursing.Both groups received nursing intervention from admission to delivery.The blood glucose control effects(fasting plasma glucose[FPG],2 hour postprandial blood glucose[2hPG]),self-care ability(self-care ability measurement scale[ESCA]),the incidence of adverse pregnancy outcomes,dietary compliance and the increase of body mass index(BMI)were compared between the two groups before and after intervention.Results After the intervention,the FPG and 2hPG of the two groups were lower than those of the same group before the intervention,and the observation group was lower than that of the control group,the differences were statistically significant(P<0.05);the ESCA scores of the two groups were higher than those of the same group before the intervention,and the observation group was higher than that of the control group,the differences were statistically significant(P<0.05);the incidence of adverse pregnancy outcomes and the increase of BMI in the observation group were lower than those of the control group,the difference was statistically significant(P<0.05);the diet compliance rate of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion DOHaD concept oriented dietary nursing can help GDM patients control weight,reduce blood sugar,improve adverse pregnancy outcomes,enhance self-care ability of patients,and improve their dietary compliance.