何颖

[摘要] 目的 探讨孕期规范化管理對妊娠期糖尿病高危产妇母婴预后的影响。 方法 分析杭州市妇产科医院2015年1月～2016年1月收治的妊娠期糖尿病高危产妇60例的临床资料，依据是否实施孕期规范化管理进行分组，对照组30例和孕期规范化管理组30例。观察两组妊娠期糖尿病高危产妇管理措施实施前后妊娠期糖尿病认知度、空腹血糖、餐后2 h血糖、糖化血红蛋白、妊娠期糖尿病高危产妇并发症和新生儿并发症情况。 结果 管理措施实施前，两组妊娠期糖尿病认知度优良率、空腹血糖、餐后2 h血糖和糖化血红蛋白差异均无统计学意义（P > 0.05）。孕期规范化管理组管理措施实施后优良率明显高于对照组（P < 0.05），对照组和孕期规范化管理组管理措施实施后空腹血糖、餐后2 h血糖和糖化血红蛋白均低于实施前（P < 0.05），孕期规范化管理组管理措施实施后空腹血糖、餐后2 h血糖和糖化血红蛋白均低于对照组（P < 0.05），孕期规范化管理组妊娠期糖尿病高危产妇并发症和新生儿并发症均低于对照组（P < 0.05）。 结论 孕期规范化管理可以提高高危产妇疾病认知度，改善血糖水平，降低并发症的发生率，值得临床推广应用。

[关键词] 孕期；规范化管理；妊娠期糖尿病；高危产妇

[中图分类号] R714 [文献标识码] A [文章编号] 1673-7210（2017）01（c）-0117-04

[Abstract] Objective To discuss influence of maternal and neonatal outcomes for GDM high-risk maternal by standardized management in the gestation. Methods The 60 clinical data of GDM high-risk puerperae in Obstetrics and Gynecology Hospital of Hangzhou City from January 2015 to January 2016 were analyzed， they were divided into two groups by implement standardized management in the gestation or not，control group with 30 cases and standardized management in gestation group with 30 cases. The awareness of GDM FBG， 2hPG and glycosylated hemoglobin of two groups GDM high-risk maternal before implement and after implement were detected. The complication of two groups GDM high-risk maternal and complication of neonate were detected. Results The excellent rate of GDM awareness， the FBG， 2hPG and glycosylated hemoglobin of two groups before implement were compared， the differences were not statistically significant （P > 0.05）. The excellent rate of standardized management in gestation group after implement was higher than that of control group （P < 0.05）， the FBG， 2hPG and glycosylated hemoglobin of control group and standardized management in gestation group after implement were lower than those before implement （P < 0.05）， the FBG， 2hPG and glycosylated hemoglobin of standardized management in gestation group after implement were lower than those in control group （P < 0.05）， the GDM high-risk maternal complication and neonate complication of standardized management in gestation group were lower than those in control group （P < 0.05）. Conclusion The standardized management in the gestation increases disease recognition of high-risk maternal，improves blood sugar level，decrease scomplications rate，it is worth to be used.

[Key words] Gestation； Standardized management； GDM； High-risk maternal

妊娠期糖尿病作为孕期常见的并发症，其是指妊娠期间首次发现或者发生糖代谢紊乱，其发生率呈现逐年升高的趋势[1-2]。临床证据显示[3-4]，妊娠期糖尿病可以对患者个体和子代的近期、远期造成很多不良影响，影响患者的身心健康[5-6]。目前关于妊娠期糖尿病管理方案各项研究中，改善患者不良生活习惯、饮食习惯成为糖尿病预防和治疗的关键所在。通过有效的孕期管理方式，可以提高产妇疾病认知水平，提高治疗依从性，降低血糖水平，为提高妊娠解决奠定基础。本研究通过分析妊娠期糖尿病孕妇的临床资料，探讨孕期规范化管理对妊娠期糖尿病高危产妇母……