黄海燕　李伟波

[摘要] 目的 探讨系统性护理干预及监测对妊娠期糖尿病（GDM）患者不良妊娠结局的预防作用。 方法 选取154例我院妇产科分娩并确诊的GDM患者，根据孕期有无进行系统性的护理干预及监测分为干预组83例和对照组71例，对照组孕产妇因个人因素未进行系统性的医疗护理干预及监测，干预组予执行严格系统性的糖尿病饮食调节方案以及治疗和护理干预。观察两组干预后血糖达标的变化，并比较其不良妊娠结局。 结果 干预后，干预组孕妇FBG和HbA1C的达标率明显高于对照组（P<0.05）；干预组孕妇干预后子痫前期、蛋白尿、早产、胎膜早破、产褥感染、新生儿窒息、巨大儿和新生儿肺炎发生率明显低于对照组（P<0.05）。 结论 系统性护理干预及监测能提高GDM患者的降糖效果，降低孕妇和新生儿的不良结局，对GDM的不良妊娠结局具有良好的预防作用。

[关键词] 糖尿病；妊娠期；系统性护理干预及监测；不良妊娠结局

[中图分类号] R473.71 [文献标识码] B [文章编号] 1673-9701（2017）06-0147-03

[Abstract] Objective To investigate the preventive effect of systemic nursing intervention and monitoring on adverse pregnancy outcome in gestational diabetes mellitus（GDM） patients. Methods 154 GDM patients who were diagnosed and delivered in the Department of Obstetrics in our hospital were selected.According to whether there was no systematic care intervention and monitoring in pregnancy， the patients were divided into intervention group with 83 cases and control group with 71 cases. In the control group， the systemic nursing intervention and monitoring were not carried out because of personal factors. The intervention group was given strict systemic diabetes dietary adjustment program and treatment and nursing intervention. The changes of blood glucose compliance between two groups were observed and the adverse pregnancy outcome was compared. Results After intervention， the compliance rate of FBG and HbA1C in the intervention group was significantly higher than that in the control group（P<0.05）. After intervention， the incidences of preeclampsia， proteinuria， premature delivery， premature rupture of membranes， puerperal infection， neonatal asphyxia， giant and neonatal pneumonia in intervention group were significantly lower than those in the control group（P<0.05）. Conclusion Systematic nursing intervention and monitoring can improve the hypoglycemic effect of GDM patients and reduce the adverse pregnancy outcomes of pregnant women and newborns， and have a good preventive effect on the adverse pregnancy outcome of GDM.

[Key words] Diabetes mellitus； Pregnancy； Systemic care intervention and monitoring； Adverse pregnancy outcome

妊娠期糖尿病（GDM）是指在妊娠期間发生或首次发现的糖尿病，其发病率约1%～5%，是妊娠中晚期常见的并发症，可导致多种产科及围产儿并发症，导致胎儿畸形甚至流产，增加母婴死亡率，严重影响母婴健康。随着人们饮食结构的变化，GDM的发病率近年来有逐年增高趋势[1-2]。对GDM孕产妇进行早期诊断、早期干预和控制血糖是减少其不良妊娠结局的关键[3-5]。近年来研究发现对GDM孕产妇在常规药物治疗基础上予以积极有效的系统性护理干预及监测可提高血糖控制效果，减少不良妊娠结局[6-8]。本研究旨在探讨系统性护理干预及监测对妊娠期糖尿病患者不良妊娠结局的预防作用，现报道如下。

1 资料与方法

1.1 一般资料

选取2011年1月～2016年6月在我院妇产科门诊就诊确诊并拟在我院分娩的GDM患者154例。……