张小艳

[摘要]目的 探討健康宣传教育对妊娠期糖尿病患者遵医行为及母婴结局的影响。方法 选取2015年7月～2017年4月我院收治的89例妊娠期糖尿病患者，采用随机数字表法将其分为对照组44例，观察组45例， 对照组实施常规护理干预，常规护理基础上进行健康宣传教育，比较两组患者遵医行为（心理调控、规律运动、合理饮食、血糖监测、遵医用药、定期产检）评分及干预前后血糖水平（空腹血糖、餐后2 h血糖）的变化情况，并统计两组患者不良母婴结局发生情况及护理满意度。结果 观察组患者遵医行为（心理调控、规律运动、合理饮食、血糖监测、遵医用药及定期产检）评分均高于对照组，差异有统计学意义（P<0.05）；干预后，观察组患者的空腹血糖及餐后2 h血糖水平低于对照组，差异有统计学意义（P<0.05）；观察组患者的不良母婴结局发生率低于对照组，差异有统计学意义（P<0.05）；观察组患者的护理满意度高于对照组，差异有统计学意义（P<0.05）。结论 健康宣传教育应用于妊娠期糖尿病患者，血糖控制效果显著，有助于提高患者遵医行为，降低不良母婴结局发生率，且护理满意度高。

[关键词]妊娠期糖尿病；健康宣传教育；遵医行为；母婴结局

[中图分类号] R473.6 [文献标识码] A [文章编号] 1674-4721（2018）4（b）-0185-04

Influence of health education on the nursing in patients with gestational diabetes mellitus

ZHANG Xiao-yan

Department of Gynecology and Obstetrics，People′s Hospital in Shanwei City of Guangdong Province，Shanwei 516600，China

[Abstract]Objective To investigate the effect of the health education on the compliance behavior and the maternal and infant outcomes in patients with gestational diabetes mellitus.Methods A total of 89 patients with gestational diabetes mellitus treated in our hospital from July 2015 to April 2017 were randomly divided into control group （n=44） and observation group（n=45）.The control group received routine nursing intervention and health publicity and education based on routine nursing.The scores of compliance behavior（psychological regulation，regular exercise，reasonable diet，blood glucose monitoring，compliance with medical drugs，regular prenatal examination） and the changes of blood glucose levels（fasting blood glucose，2 h blood glucose after meal） before and after intervention were compared between the two groups.The adverse maternal and infant outcomes and nursing satisfaction were also counted.Results The scores of compliance behavior （ psychological regulation，regular exercise，reasonable diet，blood glucose monitoring，compliance with medical drugs and regular prenatal examination） in the observation group were higher than those in the control group，the differences were statistically significant（P<0.05）.After intervention，fasting blood glucose and 2 h postprandial blood glucose in the observation group were significantly lower than those in the control group，the differences were statistically significant （P<0.05）.The incidence of adverse maternal and infant outcomes in the observation group were lower than that in the control group，the differences were statistically significant（P<0.05）.The nursing satisfaction of the observation group was higher than that of the control grou，the difference was statistically significant （P<0.05）.Conclusion The application of health education in patients with gestational diabetes mellitus has a remarkable effect on blood sugar control.It is helpful to improve the patients′ compliance behavior，and reduce the incidence of adverse maternal and infant outcomes.Besides，it has high nursing satisfaction.

[Key words]Gestational diabetes mellitus；Health education；Compliance behavior；Maternal and infant outcome

妊娠期糖尿病（Gestational diabetes mellitus，GDM）为临床常见高危妊娠，发病率较高，占妊娠女性的1%～6%，且每年以7%～18%速率增长，已成为危害母婴生命健康的主要妊娠期并发症之一[1-4]。目前对于孕妇临床多采用胰岛素注射控制其血糖水平，虽取得一定效果，但孕妇由于担心药物对胎儿产生负面影响，多伴有负性心理情绪；为保障其心理健康、提高治疗依从性，采用药物控制血糖水平的同时需辅助一定护理干预。有文献资料显示对GDM患者进行健康宣传教育，不仅可改善妊娠结局，挽救孕妇及围生儿生命，且可降低母婴并发症发生率，促进预后康复[5]。健康宣传教育为整体护理的重要组成部分，已有100多年历史，其提倡以患者为中心，遵循护理程序基本原则，结合患者需求展开健康教育干预，以充分调动患者配合治疗及护理的积极性，从而有效控制病情进展，改善预后[6-7]。……