以时效性激励理论为指导的延伸服务对妊娠期糖尿病患者血糖控制及分娩结局的影响
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摘要
目的探讨以时效性激励理论为指导的延伸服务对妊娠期糖尿病(GDM)患者血糖控制及分娩结局的影响。方法选择2016年6月～2017年12月在新疆维吾尔自治区人民医院产科门诊就诊的98例GDM患者作为研究对象,根据随机数字表法将其分为干预组和对照组,每组各49例。对照组在新疆维吾尔自治区人民医院门诊孕妇学校签到听课≥6次,干预组在门诊孕妇学校教育的基础上,给予以时效性激励理论为指导的延续护理。观察两组患者入院分娩时的空腹血糖、餐后2 h血糖、糖化血红蛋白、孕期体重增加,同时分别收集羊水过多、胎膜早破、剖宫产、新生儿低血糖、巨大儿、胎儿生长受限、新生儿呼吸窘迫发生例数。结果干预后,干预组入院时的空腹血糖、餐后2 h血糖、糖化血红蛋白、孕期体重增加均低于对照组,差异有统计学意义(P <0.05)。干预组羊水过多、胎膜早破、新生儿低血糖、巨大儿、胎儿生长受限的发生率均低于对照组,差异有统计学意义(P <0.05)。结论 GDM延续护理团队通过以时效性激励理论为指导的延伸服务,可以有效帮助GDM患者控制孕期血糖,降低GDM并发症的发生,减少不良妊娠结局的发生,对保障母婴健康有重要意义。
Objective To explore the effect of the time-sensitive incentive theory-guided extended service guided by timeliness incentive theory on blood glucose control and delivery outcome of gestational diabetes mellitus(GDM) patients. Methods Ninety-eight cases of gestational diabetes patients admitted to the outpatient department of obstetrics of Xinjiang Uygur Autonomous Region People's Hospital from June 2016 to December 2017 were selected as the research objects. According to the random number table, they were divided into the intervention group and the control group, with 49 cases in each group. In the control group, the outpatient pregnant women' s school of Xinjiang Uygur Autonomous Region People's Hospital has signed in for more than 6 lectures, while the intervention group was provided with the time-sensitive incentive theory-guided extended service on the basis of education in the pregnant women school. The fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, and pregnancy weight gain of patients in the two groups at the time of admission and delivery were observed, respectively, the number of cases of hyperhydramnios, premature rupture of membranes, cesarean section, neonatal hypoglycemia, macrosomia, fetal growth restriction, and neonatal respiratory distress were collected. Results After the intervention, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin and pregnancy weight gain in the intervention group were all lower than those in the control group at admission, with statistically significant differences(P < 0.05). The incidence of hyperhydramnios, premature rupture of membranes, hypoglycemia, macrosomia and fetal growth restriction in the intervention group was lower than that in the control group, with statistically significant differences(P < 0.05).Conclusion GDM continuous care team can effectively help GDM patients control blood glucose during pregnancy, reduce the occurrence of GDM complications and reduce the occurrence of adverse pregnancy outcomes through extended services guided by the time-sensitive incentive theory, which is of great significance to the protection of maternal and infant health.
Objective To explore the effect of the time-sensitive incentive theory-guided extended service guided by timeliness incentive theory on blood glucose control and delivery outcome of gestational diabetes mellitus(GDM) patients. Methods Ninety-eight cases of gestational diabetes patients admitted to the outpatient department of obstetrics of Xinjiang Uygur Autonomous Region People's Hospital from June 2016 to December 2017 were selected as the research objects. According to the random number table, they were divided into the intervention group and the control group, with 49 cases in each group. In the control group, the outpatient pregnant women' s school of Xinjiang Uygur Autonomous Region People's Hospital has signed in for more than 6 lectures, while the intervention group was provided with the time-sensitive incentive theory-guided extended service on the basis of education in the pregnant women school. The fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, and pregnancy weight gain of patients in the two groups at the time of admission and delivery were observed, respectively, the number of cases of hyperhydramnios, premature rupture of membranes, cesarean section, neonatal hypoglycemia, macrosomia, fetal growth restriction, and neonatal respiratory distress were collected. Results After the intervention, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin and pregnancy weight gain in the intervention group were all lower than those in the control group at admission, with statistically significant differences(P < 0.05). The incidence of hyperhydramnios, premature rupture of membranes, hypoglycemia, macrosomia and fetal growth restriction in the intervention group was lower than that in the control group, with statistically significant differences(P < 0.05).Conclusion GDM continuous care team can effectively help GDM patients control blood glucose during pregnancy, reduce the occurrence of GDM complications and reduce the occurrence of adverse pregnancy outcomes through extended services guided by the time-sensitive incentive theory, which is of great significance to the protection of maternal and infant health.
引文
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[13]马玲玲.妊娠期糖尿病管理与妊娠糖尿病母儿结局的临床分析研究[J].中国实用医药,2018,13(1):148-150.
[14]李卫文,毕红,曹森杨.妊娠糖尿病筛查与妊娠糖尿病母儿结局的临床分析[J].实用妇科内分泌电子杂志,2016,3(17):47-49.
[15] Embaby H,Elsayed E,Fawzy M. Insulin sensitivity and plasma glucose response to aerobic exercise in pregnant women at risk for gestational diabetes mellitus[J]. Ethiop J Health Sci,2016,26(5):409-414.
[16] Kayal A,Mohan V,Malanda B,et al. Women in India with gestational diabetes mellitus strategy(wings):methodology and development of model of care for gestational diabetes mellitus(WINGS 4)[J]. Indian J Endocrinol Metab,2016,20(5):707-715.
[17] Zhang Q,Cheng Y,He M,et al. Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus:a randomized controlled trial[J].Exp Ther Med,2016,12(3):1889-1895.
[18] Gorar S,Alioglu B,Ademoglu E,et al. Is there a tendency for thrombosis in gestational diabetes mellitus?[J]. J Lab Physicians,2016,8(2):101-105.
[19]胡波,马腹蝉.健康教育及饮食护理对妊娠期糖尿病孕妇妊娠结局影响[J].中国计划生育学杂志,2016,24(7):490-493.
[20]李霞,闫芳.糖皮质激素地塞米松不同给药途径对于妊娠期糖尿病患者促胎儿肺成熟的作用及其对血糖的影响[J].中国继续医学教育,2015,7(27):169-171.
[2]王娟,马秀玲,张崴,等.既往妊娠期糖尿病患者代谢综合征患病情况及炎性因子和其他因素的相关性分析[J].国际内分泌代谢杂志,2013,33(4):229-233。
[3]李小媚,于祥远,张军,等.妊娠期糖尿病相关基因多态性研究进展[J].中国糖尿病杂志,2017,25(4):371-375.
[4] Wei YM,Yan J,Yang HX. Identification of severe gestational diabetes mellitus after new criteria used in China[J].J Perinatol,2016,36(2):90-94.
[5]汪红娟,吴立萍.持续性护理干预对妊娠期糖尿病患者治疗效果的观察[J].护理与康复,2013,12(3):236-237.
[6]刘小杰,童本德,熊金萍,等.妊娠期糖尿病的生活方式干预管理[J].同济大学学报:医学版,2016,37(4):99-103.
[7]何颖.孕期规范化管理对妊娠期糖尿病高危产妇母婴预后的影响[J].中国医药导报,2017,14(3):117-120.
[8]牛瑞芝.妊娠期糖尿病早期筛查和干预对母儿围产结局的影响[J].中国优生与遗传杂志,2014,22(3):86-87.
[9]李继平.护理管理学[M].3版.北京:人民卫生出版社,2012.
[10]中华医学会妇产科学分会产科学组.妊娠合并糖尿病诊治指南(2014)[J].中华妇产科杂志,2014,49(8):489-498.
[11]吴伟珍,粱丽霞,李湘元,等.微信平台在妊娠期糖尿病医学营养健康教育中的应用[J].护理实践与研究,2016,13(2):65-67.
[12]杨依慧,王晓杰,江翠婵,等.微信平台在新生儿病房护理管理中的应用效果研究[J].中国医学创新,2016,13(22):142-144.
[13]马玲玲.妊娠期糖尿病管理与妊娠糖尿病母儿结局的临床分析研究[J].中国实用医药,2018,13(1):148-150.
[14]李卫文,毕红,曹森杨.妊娠糖尿病筛查与妊娠糖尿病母儿结局的临床分析[J].实用妇科内分泌电子杂志,2016,3(17):47-49.
[15] Embaby H,Elsayed E,Fawzy M. Insulin sensitivity and plasma glucose response to aerobic exercise in pregnant women at risk for gestational diabetes mellitus[J]. Ethiop J Health Sci,2016,26(5):409-414.
[16] Kayal A,Mohan V,Malanda B,et al. Women in India with gestational diabetes mellitus strategy(wings):methodology and development of model of care for gestational diabetes mellitus(WINGS 4)[J]. Indian J Endocrinol Metab,2016,20(5):707-715.
[17] Zhang Q,Cheng Y,He M,et al. Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus:a randomized controlled trial[J].Exp Ther Med,2016,12(3):1889-1895.
[18] Gorar S,Alioglu B,Ademoglu E,et al. Is there a tendency for thrombosis in gestational diabetes mellitus?[J]. J Lab Physicians,2016,8(2):101-105.
[19]胡波,马腹蝉.健康教育及饮食护理对妊娠期糖尿病孕妇妊娠结局影响[J].中国计划生育学杂志,2016,24(7):490-493.
[20]李霞,闫芳.糖皮质激素地塞米松不同给药途径对于妊娠期糖尿病患者促胎儿肺成熟的作用及其对血糖的影响[J].中国继续医学教育,2015,7(27):169-171.