何静+陆斌+徐蓉+马晓春+徐丽娜+崔明

摘 要 目的：运用综合教育模式对高危妊娠糖尿病孕妇的影响效果评价。方法：对于2015年5-9月符合标准的168名孕妇纳入作为研究对象，随机分为对照组及干预组各84名。对照组采用常规随访，干预组采用综合教育模式进行干预，评价两组在妊娠糖尿病发病率、孕期血糖控制等的效果。结果：干预组在妊娠糖尿病发病率、血糖控制率以及对母婴造成的影响等发生率明显优于对照组。结论：对高危的妊娠糖尿病孕妇实行孕早期的综合教育模式能显著降低孕期糖尿病发病率，提高母婴健康。

关键词 高危妊娠糖尿病 综合教育 孕早期 效果评价

中图分类号：R587.1/R714.2 文献标识码：A 文章编号：1006-1533（2016）06-0048-03

Evaluation of the effect of the comprehensive education mode on the high-risk primipara with gestational diabetes in the early pregnancy

HE Jing， LU Bin， XU Rong， MA Xiaochun， XU Lina， CUI Ming

（Yinhang Community Health Service Center of Yangpu District， Shanghai 200438， China）

ABSTRACT Objective： To evaluate the effect of the comprehensive education mode on the high-risk pregnant women with gestational diabetes. Methods： One hundred and sixty-eight pregnant women in line with the standard were included as the research subjects from May to Sept. 2015 and were randomly divided into a control group and an intervention one with 84 cases each. Those in the control group were adopted with the routine follow-up and those in the intervention group were intervened with the comprehensive education mode. The effects of the incidence of gestational diabetes， blood glucose control during the pregnancy and others were evaluated in the two groups. Results： The incidence of gestational diabetes， blood glucose control rate and incidence of their impacts on the mother and infant were significantly better in the intervention group than in the control one. Conclusion： The implementation of the comprehensive education mode in the early pregnancy on the high-risk pregnant women with gestational diabetes can significantly reduce the incidence of diabetes during the pregnancy and improve the health of the mother and infant.

KEY WORDS high risk gestational diabetes； comprehensive education； early pregnancy； effect evaluation

妊娠期糖尿病（gestational diabetes，GDM）是指妊娠期发生或首次发现不同程度的糖代谢异常[1]。从近些年的工作中发现，妊娠期糖尿病有逐渐增高的趋势。针对普通糖尿病患者的干预措施已有显著成效，而对于妊娠期糖尿病的护理干预却并不多见。历年来，对妊娠期合并糖尿病的研究大多以已确诊的患者作为研究对象[2-6]并对其进行护理干预，而对于暂未发生却存在高危因素的孕妇并未得到合理的健康教育及护理干预而错过了最佳的干预时期。本研究旨在探讨孕早期实施综合教育模式的应用效果。

我社区卫生服务中心所处地区拥有20万常住人口。据统计，每月约有150名孕妇来我院建立《上海市孕产妇健康手册》，俗称“小卡”。随后，根据自己的选择前往二、三级医院建立《上海市孕产妇保健服务记录》，俗称“大卡”，进行各项产前检查。……