妊娠期糖尿病患者经阴道分娩会阴伤口愈合的相关影响因素分析

Analysis of related influencing factors for perineal wound healing in patients with gestational diabetes mellitus undergoing vaginal delivery

目的探讨影响妊娠期糖尿病(GDM)患者经阴道分娩会阴伤口愈合的相关因素,以期为临床治疗提供参考。方法本研究选取2021年1月—2023年6月河北省廊坊市人民医院产科收治的110例GDM患者为研究对象。根据患者会阴伤口愈合情况将其分为正常愈合组(n=87)和愈合不良组(n=23)。收集患者年龄、体质量指数(BMI)、第二产程时间、孕期体质量增长、血糖控制是否达标、是否生殖道感染、伤口长度、入院后阴道操作次数、新生儿体质量、是否巨大儿、是否难产、是否中重度贫血、胎儿娩出至伤口缝合完毕时间、是否胎膜早破等临床资料。采用多因素logistic回归分析影响GDM经阴道分娩患者会阴伤口愈合的相关因素。结果愈合不良组患者BMI>30 kg/m^(2)、血糖控制未达标、胎儿娩出至伤口缝合完毕时间>30 min所占比例高于正常愈合组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示:BMI>30 kg/m^(2)、血糖控制未达标、胎膜早破是影响GDM患者经阴道分娩会阴伤口愈合的独立危险因素(P<0.05)。结论影响GDM患者经阴道分娩会阴伤口愈合的因素较多,医护人员应根据其危险因素给予针对性护理,促进患者伤口愈合。

Objective To explore the related influencing factors of perineal wound healing in patients with gestational diabetes mellitus(GDM)undergoing vaginal delivery,aiming to provide a reference for clinical treatment.Methods This study included 110 GDM patients treated in the Department of Obstetrics,People's Hospital of Langfang City from January 2021 to June 2023 as the participants.According to the perineal wound healing situation,they were assigned to a normal healing group(n=87)and a poor healing group(n=23).Clinical data including patient age,body mass index(BMI),time of the second stage of labor,pregnancy weight gain,blood sugar control,genital tract infection,wound length,number of vaginal manipulations after admission,neonatal weight,presence or absence of macrosomia,presence or absence of difficult labor,presence or absence of moderate to severe anemia,time from fetal delivery to wound suturing,and presence or absence of premature rupture of membranes were collected.Multifactorial logistic regression analysis was used to analyze the related factors affecting perineal wound healing in GDM patients receiving vaginal delivery.Results Patients in the poor healing group with BMI>30 kg/m^(2),unmet blood sugar control standards,and time from fetal delivery to wound suturing>30 min had a significantly higher proportion than the normal healing group(P<0.05).Multifactorial logistic regression analysis results showed that BMI>30 kg/m^(2),unmet blood sugar control standards,and premature rupture of membranes are independent risk factors influencing perineal wound healing in GDM patients who underwent vaginal delivery(P<0.05).Conclusion There are multiple factors affecting perineal wound healing in GDM patients who underwent vaginal delivery.Medical staff should provide targeted nursing following their risk factors to promote patient wound healing.