规范化营养护理联合运动干预在妊娠糖尿病患者产后血糖控制中的应用

Application of standardized nutritional nursing combined with exercise intervention in postpartum blood glucose control of patients with gestational diabetes mellitus

目的探讨规范化营养护理联合运动干预对妊娠糖尿病(GDM)患者产后血糖的控制效果。方法回顾性选取上海交通大学医学院附属仁济医院于2020年7月至2021年12月收治的150例GDM患者为研究对象,根据不同的干预方法分为对照组和观察组,各75例。对照组进行常规干预,观察组在常规干预的基础上采用规范化营养护理联合运动干预。比较2组入院时、产前1 d的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血清胱抑素C(Cys-C)和同型半胱氨酸(Hcy)水平,并比较2组的妊娠并发症和新生儿不良结局发生率。结果与入院时比较,2组在产前1 d的FPG、2hPG、HbA1c、Cys-C和Hcy水平均降低(P均<0.05);与对照组比较,观察组在产前1 d的FPG、2hPG、HbA1c、Cys-C和Hcy水平均降低(P均<0.05)。观察组的妊娠并发症总发生率(9.33%)明显低于对照组(49.33%),差异有统计学意义(P<0.05);观察组的新生儿不良结局总发生率(5.33%)明显低于对照组(36.00%),差异有统计学意义(P<0.05)。结论规范化营养护理联合运动干预可有效降低GDM患者的血糖水平,降低妊娠并发症发生率,改善新生儿结局。

Objective To explore the effect of standardized nutritional nursing combined with exercise intervention on the postpartum blood glucose control in patients with gestational diabetes mellitus(GDM).Methods A retrospective study was conducted on 150 GDM patients admitted to Renji Hospital,School of Medicine,Shanghai Jiao Tong University from July 2020 to December 2021.According to different intervention methods,they were divided into a control group and an observation group,each with 75 cases.The control group was given routine intervention,and the observation group was given standardized nutritional nursing combined with exercise intervention in addition to the routine intervention.The levels of fasting plasma glucose(FPG),2-hr postprandial plasma glucose,glycosylated hemoglobin(HbA1c),serum cystatin C(Cys-C),and homocysteine(Hcy)at admission and 1 day before delivery were compared between the two groups,and the pregnancy complications and adverse neonatal outcomes were compared between the two groups.Results Compared with those at admission,the levels of FPG,2-hr postprandial plasma glucose,HbA1c,Cys-C,and Hcy in the two groups decreased at 1 day before delivery(all P<0.05).Compared with the control group,the levels of FPG,2-hr postprandial plasma glucose,HbA1c,CysC,and Hcy at 1 day before delivery were lower in the observation group(all P<0.05).The total incidence of pregnancy complications in the observation group(9.33%)was significantly lower than that in the control group(49.33%),and the difference was statistically significant(P<0.05).The total incidence of adverse neonatal outcomes in the observation group(5.33%)was significantly lower than that in the control group(36.00%),and the difference was statistically significant(P<0.05).Conclusion Standardized nutritional nursing combined with exercise intervention can effectively reduce the blood glucose level of GDM patients,reduce the incidence of pregnancy complications,and improve the neonatal outcomes.