个案管理联合个体营养检测对需胰岛素治疗糖尿病孕妇的影响

Effect of case management combined with individual nutrition test on pregnant women with diabetes requiring insulin treatment

目的探讨个案管理联合个体营养检测对需胰岛素治疗糖尿病孕妇的影响。方法选取2022年10月至2024年1月赣州市妇幼保健院收治的需胰岛素治疗的80例妊娠期高血糖孕妇作为研究对象,采用随机掷硬币法将80例孕妇分为对照组和观察组,每组各40例。对照组接受常规干预,观察组在对照组的基础上给予个案管理联合个体营养检测干预,比较两组孕妇基本情况(血糖控制欠佳入院次数、妊娠结局)、干预前后血糖控制情况,采用孕期焦虑量表(PAS)比较孕妇心理状态。结果观察组孕期因血糖控制欠佳入院次数以及发生剖宫产率、羊水过多、早产、巨大儿的妊娠结局均低于对照组,差异有统计学意义(P<0.05);两组孕妇干预后空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)含量和PAS总分低于本组干预前,且观察组上述指标低于对照组,差异有统计学意义(P<0.05)。结论个案管理联合个体营养检测应用于需胰岛素治疗的糖尿病孕妇,可显著降低因血糖控制欠佳的入院次数,加强血糖控制情况,改善心理状态并收获理想妊娠结局。

Objective To investigate the effect of case management combined with individual nutrition test on pregnant women who need insulin to treat diabetes.Methods A total of 80 pregnant women with hyperglycemia during pregnancy who needed insulin treatment in Ganzhou Maternal and Child Health Hospital from October 2022 to January 2024 were selected as the study objects.The 80 pregnant women were divided into control group and observation group by random coin toss method,with 40 cases in each group.The control group received routine intervention,and the observation group was given case management combined with individual nutrition test intervention on the basis of the control group.The basic situation of pregnant women in the two groups(number of hospital admissions with poor blood glucose control and pregnancy outcome),blood glucose control before and after intervention were compared,and the psychological state of pregnant women was com-pared by using pregnancy anxiety scale(PAS).Results The number of hospital admissions due to poor blood glucose control,the rate of cesarean section,excessive amniotic fluid,premature delivery and macrosomia in the observation group were lower than those in the control group,with statistical significances(P<0.05).Fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin(HbA1c)content and PAS total score of the two groups were lower than those before inter-vention,and the above indexes of the observation group were lower than those of the control group,with statistical signifi-cances(P<0.05).Conclusion The application of case management combined with individual nutrition test in diabetic preg-nant women who need insulin treatment can significantly reduce the number of hospital admissions due to poor blood glucose control,strengthen blood glucose control,improve psychological state and obtain ideal pregnancy outcomes.