早期综合护理对妊娠期糖尿病患者血糖的影响*

耿中群1刁雪芹1曹海伟1张志敏2余章斌3

(1.徐州市妇幼保健院, 江苏 徐州 221000；2.徐州市中心医院, 江苏 徐州 221000；

3.南京医科大学附属南京妇幼保健院, 江苏 南京210029)

【摘要】目的观察早期综合护理干预对妊娠期糖尿病产妇血糖控制的影响。方法选取120例患有妊娠期糖尿病患者作为研究对象，随机将患者分为对照组60例和观察组60例。对照组患者给予合理使用胰岛素治疗和产科常规护理；观察组患者在给予合理使用胰岛素治疗和产科常规护理的基础上，对其增加饮食、运动和心理辅导等综合护理措施。在对干预后4周、8周和12周时的空腹血糖(FPG)、餐后2h血糖(2hPG)和糖化血红蛋白(HbA1c)水平进行观察和分析。结果在干预4周、8周和12周后两组患者FPG、2hPG和HbA1c水平均较干预前下降，差异均有显著统计学意义(P<0.05)。同时发现，干预后对应时间点观察组患者FPG、2hPG和HbA1c水平较对照组更低，差异均有显著统计学意义(P<0.05)。结论早期综合护理干预对控制妊娠期糖尿病患者的血糖有较好的临床意义，有一定的推广应用价值。

【关键词】早期综合护理干预； 妊娠期糖尿病； 空腹血糖(FPG)； 餐后2h血糖(2hPG)； 糖化血红蛋白(HbA1c)

【中图分类号】R 714.256

【文献标志码】A

doi：10.3969/j.issn.1672-3511.2015.10.042

Abstract【】ObjectiveTo observe the value of early comprehensive nursing intervention on blood glucose control in patients with gestational diabetes mellitus. MethodsIn our current study, 120 patients with gestational diabetes mellitus (GDM) were included and randomly assigned into two groups, insulin treatment with routine obstetric nursing group (control group) and insulin treatment with early comprehensive nursing group (observe group), with 60 in each. After 4 weeks, 8 weeks and 12 weeks of intervention, blood glucose `([fasting plasma glucose (FPG) and 2h postprandial blood glucose (2hPG)]) and glycosylated hemoglobin (HbA1c) were measured. ResultsAfter 4 weeks, 8 weeks and 12 weeks of intervention, FPG, 2hPG and HbA1c were all largely reduced in both groups (P<0.05 in all). Meanwhile, we also found that these reduction of FPG, 2hPG and HbA1c in observe group were significant than in control group at each time points (P<0.05 in all). Conclusion In summary, our data indicated that early comprehensive nursing intervention could be an effective and useful way for blood glucose control in patients with gestational diabetes mellitus (GDM).

基金项目：国家自然科学基金(81070500)

通讯作者：刁雪芹，E-mail:zong2015@sina.com

收稿日期：( 2015-04-14； 编辑： 陈舟贵)

ThevalueofearlycomprehensivenursinginterventiononbloodglucosecontrolinpatientswithgestationaldiabetesmellitusGENGZhongqun1, DIAO Xueqin1, CAO Haiwei1,et al

(1.Xuzhou Maternity and Child Health Care Hospital, Xuzhou 221000, Jiangsu, China;

2. Xuzhou Central Hospital, Xuzhou 221000, Jiangsu, China;

3. Nanjing Medical University Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing 210029, China)

【Keywords】Earlycomprehensivenursingintervention;Gestationaldiabetesmellitus;Fastingplasmaglucose,Twohourspostprandialbloodglucose;Glycosylatedhemoglobin

妊娠期糖尿病(gestationaldiabetesmellitus,GDM)是妊娠期妇女的常见疾病[1～8]。根据流行病学研究发现我国妊娠糖尿病的发病率在5%左右，同时由于饮食和环境因素的作用我国妊娠糖尿病的发病率呈逐步上升的趋势[1～8]。妊娠糖尿病由于临床过程复杂，对母体和胎儿的影响均较大，是临床的棘手问题。目前妊娠糖尿病的药物治疗仍然以胰岛素制剂为主，故患者教育、运动与饮食等综合护理干预措施对于该病的治疗就更加重要。……