余金花

[摘要]目的 探讨综合护理管理对妊娠糖尿病患者血糖控制的效果。方法 选择我院2015年1月～2016年12月收治的GDM患者73例，均为初产妇。按照随机数字表法分为观察组（40例）和对照组（33例）。对照组给予常规护理干预，观察组在对照组基础上给予综合护理管理模式。主要包括心理干预、运动干预、一对一指导、预防感染、出院指导、产后指导，比较两组护理干预效果。结果 观察组患者剖宫产、2型糖尿病、糖耐量异常发生率低于对照组，GQOLI-74各项评分均高于对照组，差异有统计学意义（P<0.05）。干预前，两组患者SAS、SDS评分结果比较，差异均无统计学意义（P>0.05）；干预后观察组SAS、SDS评分低于对照组，差异有统计学意义（P<0.05）。结论 综合护理管理干预措施有有利于疾病的康复，降低剖宫产率。

[关键词]护理；妊娠糖尿病；血糖

[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2017）08（a）-0185-03

[Abstract]Objective To investigate the effect of comprehensive nursing management on blood glucose control in gestational diabetes mellitus （GDM） patients.Methods 73 cases of GDM patients admitted from January 2015 to December 2016 in our hospital were all primipara.The patients were divided into observation group （40 cases） and control group （33 cases） according to random number table method.The control group was given routine nursing intervention，and the observation group was given comprehensive nursing management mode on the basis of the control group.Mainly including psychological intervention，exercise intervention，one to one guidance，prevention of infection，discharge guidance，postpartum guidance.The effect of nursing intervention in two groups were compared between two groups.Results The rate of cesarean section，diabetes mellitus type 2 and abnormal glucose tolerance in the observation group were lower than those in the control group，and the differences were statistically significant （P<0.05）.Before intervention，there were no significant differences among the scores of SAS and SDS in two groups （P>0.05）；after intervention，the scores SAS and SDS in the observation group were higher than those in the control group，and the differences were statistically significant （P<0.05）.Conclusion Comprehensive nursing management intervention is beneficial to the rehabilitation of diseases and lower the rate of cesarean section.

[Key words]Nursing；Gestational diabetes mellitus；Blood sugar

妊娠期糖尿病（GDM）是指孕妇在妊娠期发生糖尿病或糖代谢异常，或妊娠前有潜在的糖耐量减退[1]，妊娠期才出现或发现糖尿病，是糖尿病的一种特殊類型，也是女性在妊娠期间较常见的病症。全世界范围内GDM发病率占产妇的1%～15%，我国发生率1%～5%，不易发现，漏诊率高。GDM近年来有明显增高的趋势，GDM患者糖代谢多数于产后可恢复正常，但是患者将来2型糖尿病的发病率会增加，若治疗不及时，极可能造成严重的后果，是引起妊高症、胎儿窘迫以及巨大儿的主要因素之一，影响产妇的分娩质量，严重者甚至危害母婴生命安全[2]。由于糖尿病孕妇的临床经过较复杂，对母子的生命安全都造成威胁，因此临床应给予高度重视。本文对我院采用综合护理管理模式对GDM的干预效果进行回顾性分析，现报道如下。……