血糖管理团队全程管理妊娠糖尿病的临床指导及应用分析

Clinical guidance and application analysis of the whole process management of blood glucose management team in gestational diabetes mellitus

目的探讨血糖管理团队全程管理在妊娠糖尿病患者中的应用及临床指导效果。方法选择2020年1月至2021年1月萍乡市人民医院内分泌科收治的96例妊娠糖尿病患者作为研究对象,所有患者均经医院门诊口服75 g葡萄糖耐量实验检查确诊,采用随机数字表法将入选患者分为对照组与观察组,各48例。对照组接受内分泌一日门诊指导,观察组联合血糖管理团队全程管理,督促患者产后6周到6个月内复查。比较两组的自我管理水平、低血糖发生率、空腹血糖达标率、餐后血糖达标率、产后转归率、产妇及新生儿并发症发生率。结果观察组管理后的预防处理异常血糖、饮食控制、血糖监测、活动、用药以及足部护理评分高于对照组,差异有统计意义(P<0.05);观察组管理后的低血糖发生率低于对照组,差异有统计意义(P<0.05);观察组管理后的空腹血糖达标率、餐后血糖达标率、产后转归率高于对照组,差异有统计意义(P<0.05);观察组管理后的产妇羊水过多、胎膜早破及产褥感染总发生率和新生儿巨大儿、早产儿及新生儿低血糖总发生率低于对照组,差异有统计意义(P<0.05)。结论血糖管理团队全程管理用于妊娠糖尿病患者中,有助于提高患者的自我管理水平,降低产妇、新生儿并发症发生率,提升空腹血糖达标率、餐后血糖达标率及产后转归率,值得推广应用。

Objective To explore the application and clinical guidance effect of the whole process management of blood glucose management team in patients with gestational diabetes mellitus.Methods From January 2020 to January 2021,96 patients with gestational diabetes mellitus admitted to the Department of Endocrinology of Pingxiang People′s Hospital were selected as research subjects.All the patients were diagnosed by oral 75 g glucose tolerance test in the outpatient department of the hospital,and the patients were divided into the control group and the observation group according to random number table methods,48 cases in each group.The control group received a one-day clinic instruction of endocrinology,and the observation group combined with the whole process management of blood glucose management team,and urging patients to reexamine within 6 weeks to 6 months after delivery.The self-management level,the incidence of hypoglycemia,the compliance rate of fasting blood glucose,the compliance rate of postprandial blood glucose,the rate of postpartum prognosis and the incidence of maternal and neonatal complications were compared between the two groups.Results The scores of prevention and treatment of abnormal blood glucose,diet control,blood glucose monitoring,activity,medication and foot care in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of hypoglycemia in the observation group after management was lower than that in the control group,and the difference was statistically significant(P<0.05).The compliance rate of fasting blood glucose,the compliance rate of postprandial blood glucose,the rate of postpartum prognosis in the observation group after management were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of polyhydramnios,premature rupture of membranes,puerperal infection and neonatal macrosomia,premature infants and neonatal hypoglycemia in the observation group after intervention were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The whole process management of blood glucose management team for gestational diabetes mellitus patients is helpful to improve the self-management level of patients,reduce the incidence of maternal and neonatal complications,and improve the achievement rate of fasting blood glucose,postprandial blood glucose and postpartum outcome rate,which is worthy of popularization and application.