優化血糖監測流程對妊娠期糖尿病孕婦的影響

Influence on outcome of gestational diabetes mellitus pregnant women after optimizing the blood sugar management

目的探討通過產前保健中心與糖尿病中心緊密合作,優化、規範血糖管理流程,觀察對妊娠期糖尿病孕婦妊娠結局的影響。方法選擇2013年及2014年529例於澳門鏡湖醫院產檢,診斷為妊娠期糖尿病(GDM)的孕婦,轉到糖尿病中心接受宣教、指導飲食、運動、血糖監測等一系列管理措施,2013年有204例,2014年有325例,比較這2年在不同血糖管理流程下,到糖尿病中心監測血糖人數、血糖控制滿意率及不良妊娠結局等三方面的差異。結果2014年GDM孕婦到糖尿病中心監測血糖的監測率比2013年明顯上升(P<0.05)。2014年血糖控制滿意率比2013年明顯升高(P<0.05)。GDM孕婦發生妊娠期高血壓疾病、羊水過多明顯降低(P<0.05),而巨大兒、早產、新生兒窒息、剖宮產等發生率差異無統計學意義(P>0.05)。結論經過產前保健中心與糖尿病中心緊密合作,對相關流程進行優化,增加GDM孕婦監測血糖的依從性和血糖監控的滿意率,從而降低GDM孕婦不良妊娠結局。

Objective To discuss co-operation between Prenatal Care Center and Diabetes Center,to observe the influence on outcome of gestational diabetes mellitus pregnant women after optimizing the blood sugar management.Methods Five hundred and twenty nine pregnant women diagnosed with GDM in Kiang Wu Hospital were enrolled for study,of which 204 cases in 2013 and 325 cases in 2014.These pregnant women were referred to the Diabetes Center of the hospital in order to achieve a series of management measures such as dietary control,exercise and blood sugar monitoring.The following parameters in 2014 and 2013 were compared:the numbers of GDM pregnant women attending the Diabetes Center of the hospital for monitoring blood sugar level,blood sugar control satisfaction rate and the undesirable pregnancy outcome.Results Compared with 2013,the number of blood sugar monitoring rate in 2014 for the GDM pregnant women at the Diabetes Center was significantly increased(P<0.05).Satisfaction rate of blood sugar control in 2014 was significantly higher than in 2013(P<0.05).The incidences of the hypertensive disorders and polyhydramnios in the GDM pregnant women in 2014 were significantly decreased when compared with 2013(P<0.05),while the difference in the incidence of macrosomia,preterm birth,neonatal asphyxia,cesarean section between two years were not statistically significant(P>0.05).Conclusion After optimizing the processes and enhancing the compliance of the GDM pregnant women to monitor blood sugar via cooperation between Prenatal Care Center and Diabetes Center,the satisfaction rate of control blood glucose,and the reduction of the undesirable pregnancy outcomes have been achieved in our hospital.