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目的探讨个体化健康宣教与自我管理对妊娠糖尿病患者的作用,分析其临床结局。方法 2009年收治单胎GDM病例(n=60),入组病例均接受健康宣教,向其阐述自我管理的重要性,制定个体化的管理计划,包括营养教育、运动建议、心理辅导。发放一周膳食记录表,详尽记录进食情况、体重变化及餐后2h血糖,根据记录进行能量及能量营养素摄入计算,并分析孕期体重变化、餐后2h血糖(2hPG),总结新生儿出生体重,羊水异常、早产等的发生率。结果持续自我管理第1w至第4w能量摄入均值为2062kcal/d,与目标值相比较P>0.05,均不具有显著性差异。孕期增重达标率为65%,自我管理阶段平均增重速度为0.38kg/w。自我管理期间监测2hPG1168次,其中15.6%超过6.7mmol/L,2.98%低于4.4 mmol/L。60例中早产3例,巨大儿2例,不存在低出生体重儿及新生儿Apgar’s评分1′<10的情况。结论个体化健康宣教和自我管理对改善妊娠结局具有较好的效果。
Objective To explore the effect of individualized health education and self-management on patients with gestational diabetes mellitus, and analyze its clinical outcome. Methods One single fetus with GDM (n = 60) was enrolled in 2009. All patients were enrolled in health education to explain the importance of self - management and formulate individualized management plans including nutrition education, exercise advice and counseling. One week’s dietary record sheet was issued. The food intake, body weight changes and postprandial 2-hour blood glucose were recorded in detail. Energy and energy intake were calculated according to the records. Weight changes during pregnancy, 2h postprandial blood glucose (2hPG) Amniotic fluid abnormalities, such as the incidence of preterm birth. Results Continuous self-management energy intake from 1w to 4w average 2062kcal / d, compared with the target value P> 0.05, were not significantly different. Pregnancy weight gain compliance rate of 65%, self-management phase average weight gain rate of 0.38kg / w. During the self-management period, 1168 h were monitored for 2hPG, with 15.6% exceeding 6.7 mmol / L and 2.98% below 4.4 mmol / L. Among the 60 cases, 3 were premature delivery and 2 were macrosomia. There was no 1 case of low birth weight children and neonatal Apgar’s score 1 ’<10. Conclusion Individualized health education and self-management have a good effect on improving pregnancy outcome.