全程健康教育对妊娠期糖尿病患者血糖及母婴结局的影响

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目的探讨全程健康教育对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖及母婴结局的影响。方法选择2015年5月-2016年4月丽水市中心医院收治的GDM患者230例,随机分为对照组和观察组,对照组106例,未能完成全程健康教育干预;观察组124例,均完成全程健康教育干预。评估两组血糖控制效果、健康教育知识和依从性评分;检测干预前后空腹血糖(FPG)、餐后2 h血糖(2h PG)及糖化血红蛋白(Hb A1c)水平,记录母婴结局。结果观察组患者干预后血糖控制有效率为83.06%,对照组为71.70%,两组比较,差异有统计学意义(P<0.05)。观察组健康教育知识评分为(38.31±3.27)分,依从性评分为(37.54±3.85)分,对照组分别为(32.65±3.86)分和(30.13±3.29)分,两组比较,差异有统计学意义(P<0.05)。观察组患者干预后FPG、2h PG和Hb A1c水平分别为(6.12±1.19)mmol/L、(7.32±2.26)mmol/L和(6.28±1.05)%,对照组为(6.43±1.02)mmol/L、(7.70±2.18)mmol/L和(6.90±1.14)%,两组比较,差异有统计学意义(P<0.05)。观察组患者顺产率为60.48%,对照组为54.72%,两组比较,差异有统计学意义(P<0.05)。观察组母婴不良结局发生率分别为4.03%和8.87%,对照组为9.43%和14.15%,两组比较,差异有统计学意义(P<0.05)。结论全程健康教育干预可有效提高GDM患者血糖控制效果,患者对糖尿病的知识掌握和日常管理均显著提高,母婴不良结局率下降。 Objective To investigate the effects of total health education on blood glucose and maternal and infant outcomes in patients with gestational diabetes mellitus (GDM). Methods 230 cases of GDM patients admitted to Lishui Central Hospital from May 2015 to April 2016 were randomly divided into control group, observation group and control group, 106 cases failed to complete health education intervention. 124 cases in observation group Complete health education intervention. The levels of fasting blood glucose (FPG), 2h postprandial blood glucose (2h PG) and Hb A1c before and after the intervention were measured before and after the intervention. The maternal and infant outcomes were recorded. Results In the observation group, the effective rate of blood glucose control after intervention was 83.06% and that of the control group was 71.70%. There was significant difference between the two groups (P <0.05). The score of health education in the observation group was (38.31 ± 3.27) points, the compliance score was (37.54 ± 3.85) points, and the control group was (32.65 ± 3.86) points and (30.13 ± 3.29) points respectively. There was statistical difference between the two groups Significance (P <0.05). The levels of FPG, 2h PG and Hb A1c in the observation group were (6.12 ± 1.19) mmol / L, (7.32 ± 2.26) mmol / L and (6.28 ± 1.05)%, respectively, and those in the control group were (6.43 ± 1.02) mmol / L, (7.70 ± 2.18) mmol / L and (6.90 ± 1.14)%, respectively. There was significant difference between the two groups (P <0.05). The patients in the observation group had a birth rate of 60.48% and the control group was 54.72%. There was significant difference between the two groups (P <0.05). The incidence of maternal and child adverse outcomes in the observation group was 4.03% and 8.87% respectively, while that in the control group was 9.43% and 14.15% respectively. There was significant difference between the two groups (P <0.05). Conclusion The intervention of health education can effectively improve the blood sugar control effect of GDM patients. The patients’ knowledge of diabetes and daily management are significantly increased, and the maternal and infant adverse outcomes are decreased.
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