论文部分内容阅读
目的探讨两种不同的营养干预模式对妊娠期糖尿病孕妇的血糖及产科并发症的影响。方法 220名妊娠期糖尿病孕妇按1:1随机分为连续性医学营养治疗组(研究组)和传统营养健康教育组(对照组),研究组给予个性化医学营养治疗及自我血糖监测方法,整个孕期连续性营养监测指导不少于6次,对照组给予传统饮食指导和健康教育,整个孕期只进行1次指导,2周监测一次餐后2h血糖直至妊娠结束。观察两组血糖控制情况及产科并发症。结果两组孕妇在教育前餐后2h血糖无统计学意义(t=0.87,P=0.39)。而两组干预后餐后2h血糖均有下降,两组干预前后均有统计学意义(t=15.78,P<0.01;t=9.04,P<0.01)。研究组干预前后的下降值明显高于对照组,组间比较差异有统计学意义(t=4.71,P<0.01)。两组的产科并发症比较中发现,在早产儿发生率、产时失血量方面差异没有统计学意义;在羊水过多、妊高征、巨大儿、新生儿体重、分娩方式、胎膜早破等方面,研究组低于对照组,差异有统计学意义。结论连续性医学营养治疗模式更有助于妊娠期糖尿病孕妇控制血糖和降低产科并发症,值得临床推广。
Objective To investigate the effects of two different nutritional interventions on blood glucose and obstetric complications in pregnant women with gestational diabetes mellitus. Methods 220 pregnant women with gestational diabetes mellitus were randomly divided into continuous medical nutrition group (study group) and traditional nutrition health education group (control group) according to the ratio of 1: 1. The study group was given personalized medical nutrition therapy and self blood glucose monitoring method. Continuous nutrition monitoring during pregnancy guidance of not less than 6 times, the control group to give the traditional dietary guidance and health education, only one guide during pregnancy, 2 weeks to monitor blood glucose 2h after a meal until the end of pregnancy. Observe the two groups of blood glucose control and obstetric complications. Results There was no significant difference in blood glucose between the two groups before mealtime 2h after education (t = 0.87, P = 0.39). However, both groups had a decrease in blood glucose 2h after meal, both before and after the intervention (both t = 15.78, P <0.01; t = 9.04, P <0.01). The decline of the study group before and after intervention was significantly higher than that of the control group, the difference between the two groups was statistically significant (t = 4.71, P <0.01). Comparisons of obstetric complications between the two groups found no significant difference in the incidence of preterm birth and the amount of blood lost during labor; in polyhydramnios, PIH, macrosomia, newborn birth weight, mode of delivery, premature rupture of membranes And so on, the research group is lower than the control group, the difference was statistically significant. Conclusion Continuous medical nutrition treatment model is more helpful for gestational diabetes pregnant women to control blood sugar and reduce obstetric complications, worthy of clinical promotion.