食物交换份法模式对孕妇及胎儿体重的科学管理作用
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摘要
目的:探讨临床产科针对孕妇开展营养指导过程中引入食物交换份法模式,对孕妇及胎儿体重的科学管理作用。方法:选择2015年3月-2017年6月在本院产检并分娩的初产妇300例,依据孕妇意愿将其分为对照组150例行常规营养指导和试验组150例引入食物交换份法科学管理模式。同时,依据孕妇孕前BMI值将其分为A组和B组,BMI<23 kg/m~2者为A组,包括试验组A和对照组A两个亚组,分别为80例和78例;BMI≥23 kg/m~2者为B组,包括试验组B和对照组B两个亚组,分别为70例和72例。对比各组新生儿结局和妊娠结局。结果:试验组A分娩前BMI、舒张压、新生儿出生体重均明显低于对照组A;试验组B分娩前BMI、收缩压、舒张压、新生儿出生体重均明显低于对照组B,差异均有统计学意义(P<0.05)。试验组A产后出血、巨大儿、胎儿生长受限、胎儿窘迫及妊娠高血压、糖尿病发生率均明显低于对照组A;试验组B巨大儿、妊娠期糖尿病、高血压发生率均明显低于对照组B,差异均有统计学意义(P<0.05)。试验组阴道分娩率明显高于对照组,剖宫产率明显低于对照组,差异均有统计学意义(P<0.05)。结论:针对临床产科孕妇,在孕期行营养指导干预时,引入食物交换份法科学管理模式,可有效对胎儿体质量予以控制,降低生长受限新生儿发生率,具有非常重要的开展价值。
Objective:To explore the scientific management effect of pregnant women and fetal weight by introducing food exchange method mode in the process of nutrition instruction in clinical obstetrics. Method:A total of 300 primiparous women who were examined and delivered in our hospital from March 2015 to June 2017 were selected,according to the wishes of pregnant women,they are divided into control group 150 cases and experimental group 150 cases.The control group was guided by routine nutrition guidance,the experimental group was introduced into the scientific management mode of food exchange method.At the same time,according to the BMI values of pregnant women before pregnancy,they were divided into group A and group B,BMI<23 kg/m~2 was group A,including the experimental group A and the control group A two subgroups,80 cases and 78 cases respectively;BMI≥23 kg/m~2 was B group,including experimental group B and the control group B two subgroups,70 cases and 72 cases respectively.The neonatal outcomes and pregnancy outcomes were compared in each group.Result:The BMI values before delivery,diastolic pressure and newborn birth weight of the experimental group A were significantly lower than those of the control group A,the BMI values before delivery,systolic pressure,diastolic pressure and newborn birth weight of the experimental group B were significantly lower than those of the control group B,the differences were statistically significant(P<0.05).The rates of postpartum hemorrhage,giant infant,fetal growth restriction,fetal distress and pregnancy hypertension and diabetes mellitus in the experimental group A were significantly lower than those in the control group A;the rates of giant infant,pregnancy diabetes mellitus and hypertension in the experimental group B were significantly lower than those in the control group B,the differences were statistically significant(P<0.05).The rate of vaginal delivery in the experimental group was significantly higher than that in the control group,the cesarean section rate was significantly lower than that in the control group,the differences were statistically significant(P<0.05). Conclusion:The introduction of scientific management mode of food exchange method can effectively control the body mass of the fetus and reduce the incidence rate of the newborn with growth restriction,which is of great value in carrying out nutritional guidance intervention during pregnancy for the pregnant women in clinical obstetrics.
Objective:To explore the scientific management effect of pregnant women and fetal weight by introducing food exchange method mode in the process of nutrition instruction in clinical obstetrics. Method:A total of 300 primiparous women who were examined and delivered in our hospital from March 2015 to June 2017 were selected,according to the wishes of pregnant women,they are divided into control group 150 cases and experimental group 150 cases.The control group was guided by routine nutrition guidance,the experimental group was introduced into the scientific management mode of food exchange method.At the same time,according to the BMI values of pregnant women before pregnancy,they were divided into group A and group B,BMI<23 kg/m~2 was group A,including the experimental group A and the control group A two subgroups,80 cases and 78 cases respectively;BMI≥23 kg/m~2 was B group,including experimental group B and the control group B two subgroups,70 cases and 72 cases respectively.The neonatal outcomes and pregnancy outcomes were compared in each group.Result:The BMI values before delivery,diastolic pressure and newborn birth weight of the experimental group A were significantly lower than those of the control group A,the BMI values before delivery,systolic pressure,diastolic pressure and newborn birth weight of the experimental group B were significantly lower than those of the control group B,the differences were statistically significant(P<0.05).The rates of postpartum hemorrhage,giant infant,fetal growth restriction,fetal distress and pregnancy hypertension and diabetes mellitus in the experimental group A were significantly lower than those in the control group A;the rates of giant infant,pregnancy diabetes mellitus and hypertension in the experimental group B were significantly lower than those in the control group B,the differences were statistically significant(P<0.05).The rate of vaginal delivery in the experimental group was significantly higher than that in the control group,the cesarean section rate was significantly lower than that in the control group,the differences were statistically significant(P<0.05). Conclusion:The introduction of scientific management mode of food exchange method can effectively control the body mass of the fetus and reduce the incidence rate of the newborn with growth restriction,which is of great value in carrying out nutritional guidance intervention during pregnancy for the pregnant women in clinical obstetrics.
引文
[1]杨若雅,贾金平,胡玲.食物交换份法进行体质量管理的研究[J].中国现代医学杂志,2014,24(12):63-65.
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[3]刘培艳,吴莉莉,肖小敏.孕期脂质过氧化作用与妊娠期糖尿病的相关性探讨[J].新医学,2012,43(8):545-548.
[4]Sugiyama T,Nagao K,Metoki H,et al.Pregnancy outcomes of gestational diabetes mellitus according to pre-gestational BMI in a retro spective multi-institutional study in Japan[J].Endocr J,2014,61(4):373-380.
[5]陈燕玲,周夫,黄志玲,等.基于食物交换法的营养干预对妊娠糖尿病患者血糖的影响[J].临床医学工程,2017,24(7):1021-1022.
[6]王颖,杨莎,冯辉,等.健康教育联合营养干预综合治疗对妊娠期糖尿病的影响[J].实用预防医学,2017,15(3):347-348.
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[8]蒋曼,吴雅丽,陈秋娜.食物交换份法饮食干预对妊娠期糖尿病孕妇的影响[J].护理实践与研究,2016,13(6):15-17.
[9]张宏秀,赵冬梅,陈文玮.妊娠期糖耐量异常孕妇胰岛素抵抗与不良妊娠结局的关系[J].中国妇幼保健,2013,28(30):4942-4945.
[10]杨丽雅,胡艳飞,张亚飞,等.血糖指数结合血糖负荷在糖耐量异常患者饮食教育中的应用及评价[J].护士进修杂志,2012,27(11):1001-1003.
[11]孙珂,陈妙霞,梁骊敏.基于血糖负荷概念的食物交换份法饮食干预对妊娠期糖尿病孕妇的影响[J].护理研究,2013,27(12):3862-3864.
[12]盖筱莉,焦瑞霞.基于血糖负荷概念的食物交换份法用于妊娠期糖尿病饮食干预的研究[J].中国妇幼保健,2012,27(7):993-994.
[13]Shek N W,Ngai C S,Lee C P,et al.Lifestyle modifications in the development of diabetes mellitus and metabolic syndrome in Chinese women who had gestational diabetes mellitus:a randomized interventional trial[J].Arch Gynecol Obstet,2014,289(2):319-327.
[14]赵庆霞,赵莎莎,王霞.医学营养干预治疗对降低妊娠糖尿病(GDM)发生率的效果探讨[J].糖尿病新世界,2016,19(23):124-125.
[15]邓莉莉,陈玲.妊娠糖尿病患者营养治疗的临床研究[J/OL].世界最新医学信息文摘:连续性电子期刊,2017,16(9):115-117.
[16]刘丽霞,李翠苑,张海燕.食物交换份法指导孕前超重/肥胖孕妇饮食的疗效观察[J].齐齐哈尔医学院学报,2013,34(15):2235-2237.
[17]詹望桃,陈沁,于佳,等.妊娠期糖尿病营养门诊食物交换份法干预妊娠结局分析[J].中国妇幼健康研究,2012,23(6):733-735.
[18]Guo Y,Liu Y,He J R,et al.Changes in Birth Weight beween2002 and 2012 in Guangzhou,China[J].PLoS One,2014,9(12):e115703.
[19]Sangeetha S,Fatimah A,Rohana A G,et al.Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus[J].Malays J Nutr,2013,19(1):9-23.
[20]邝清梅,陈文英,王艳.食物交换法对妊娠结局的影响[J].实用预防医学,2015,22(9):1105-1107.
[2]丁丽丽,程博,杨子艳.个体化孕期营养指导对孕妇体质量的影响[J].中国食物与营养,2011,17(4):81-85.
[3]刘培艳,吴莉莉,肖小敏.孕期脂质过氧化作用与妊娠期糖尿病的相关性探讨[J].新医学,2012,43(8):545-548.
[4]Sugiyama T,Nagao K,Metoki H,et al.Pregnancy outcomes of gestational diabetes mellitus according to pre-gestational BMI in a retro spective multi-institutional study in Japan[J].Endocr J,2014,61(4):373-380.
[5]陈燕玲,周夫,黄志玲,等.基于食物交换法的营养干预对妊娠糖尿病患者血糖的影响[J].临床医学工程,2017,24(7):1021-1022.
[6]王颖,杨莎,冯辉,等.健康教育联合营养干预综合治疗对妊娠期糖尿病的影响[J].实用预防医学,2017,15(3):347-348.
[7]Wojcik M,Zieleniak A,Macmarcjanek K,et al.The elevated gene expression level of the A(2B)adenosine receptor is associated with hyperglycemia in women with gestational diabetes mellitus[J].Diabetes Metab Res Rev,2014,30(1):42-53.
[8]蒋曼,吴雅丽,陈秋娜.食物交换份法饮食干预对妊娠期糖尿病孕妇的影响[J].护理实践与研究,2016,13(6):15-17.
[9]张宏秀,赵冬梅,陈文玮.妊娠期糖耐量异常孕妇胰岛素抵抗与不良妊娠结局的关系[J].中国妇幼保健,2013,28(30):4942-4945.
[10]杨丽雅,胡艳飞,张亚飞,等.血糖指数结合血糖负荷在糖耐量异常患者饮食教育中的应用及评价[J].护士进修杂志,2012,27(11):1001-1003.
[11]孙珂,陈妙霞,梁骊敏.基于血糖负荷概念的食物交换份法饮食干预对妊娠期糖尿病孕妇的影响[J].护理研究,2013,27(12):3862-3864.
[12]盖筱莉,焦瑞霞.基于血糖负荷概念的食物交换份法用于妊娠期糖尿病饮食干预的研究[J].中国妇幼保健,2012,27(7):993-994.
[13]Shek N W,Ngai C S,Lee C P,et al.Lifestyle modifications in the development of diabetes mellitus and metabolic syndrome in Chinese women who had gestational diabetes mellitus:a randomized interventional trial[J].Arch Gynecol Obstet,2014,289(2):319-327.
[14]赵庆霞,赵莎莎,王霞.医学营养干预治疗对降低妊娠糖尿病(GDM)发生率的效果探讨[J].糖尿病新世界,2016,19(23):124-125.
[15]邓莉莉,陈玲.妊娠糖尿病患者营养治疗的临床研究[J/OL].世界最新医学信息文摘:连续性电子期刊,2017,16(9):115-117.
[16]刘丽霞,李翠苑,张海燕.食物交换份法指导孕前超重/肥胖孕妇饮食的疗效观察[J].齐齐哈尔医学院学报,2013,34(15):2235-2237.
[17]詹望桃,陈沁,于佳,等.妊娠期糖尿病营养门诊食物交换份法干预妊娠结局分析[J].中国妇幼健康研究,2012,23(6):733-735.
[18]Guo Y,Liu Y,He J R,et al.Changes in Birth Weight beween2002 and 2012 in Guangzhou,China[J].PLoS One,2014,9(12):e115703.
[19]Sangeetha S,Fatimah A,Rohana A G,et al.Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus[J].Malays J Nutr,2013,19(1):9-23.
[20]邝清梅,陈文英,王艳.食物交换法对妊娠结局的影响[J].实用预防医学,2015,22(9):1105-1107.