医师、营养师、心理咨询师共同管理对妊娠糖尿病患者血糖控制及妊娠结局的影响

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摘要目的探讨医师、营养师、心理咨询师共同管理对妊娠糖尿病（GDM）患者血糖控制及妊娠结局的影响。方法选取2016年2月～2018年12月在我院就诊及分娩的120例妊娠期糖尿病患者作为研究对象，按就诊顺序编码，采用随机数字表法将其分为观察组和对照组，每组各60例。对照组患者采用常规管理，观察组患者采用医师、营养师、心理咨询师共同管理。比较两组患者的空腹血糖、餐后2 h 血糖水平、分娩前治疗依从性、自我管理能力、妊娠结局、新生儿结局。结果干预后，两组的空腹血糖、餐后2 h 血糖低于干预前，差异有统计学意义（P＜0.05）。干预后，两组的空腹血糖、餐后2 h 血糖比较，差异无统计学意义（P＞0.05）。观察组的完全依从率和总依从率高于对照组，不能依从率低于对照组，差异有统计学意义（P＜0.05）。观察组的自我管理态度、饮食依从性、运动问题、血糖监测问题评分高于对照组，差异有统计学意义（P＜0.05）。观察组产妇的自然分娩率高于对照组，剖宫产率低于对照组，差异有统计学意义（P＜0.05）。观察组产妇的不良妊娠结局总发生率低于对照组，差异有统计学意义（P＜0.05）。观察组的新生儿不良结局总发生率低于对照组，差异有统计学意义（P＜0.05）。结论医师、营养师、心理咨询师共同管理，通过微信平台进行具体的饮食搭配、运动指导、心理疏导、控制血糖，提高妊娠糖尿病患者治疗的依从性和自我管理能力，有效降低母婴并发症。

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	刘艳丽
	钟义春
	陈晓正
	何健敏
	林慧卿
	陈香华

关键词 ：妊娠糖尿病, 医师、营养师、心理咨询师共同管理, 血糖控制, 妊娠结局

Abstract：Objective To investigate the effect of co-management of physicians, nutritionists and psychologists on blood glucose control and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods A total of 120 patients with gestational diabetes mellitus who were treated and delivered in our hospital from February 2016 to December 2018 were selected as the research objects.The patients were coded in order of visit and divided into observation group and control group by random number table method, with 60 cases in each group.Routine management was adopted in the control group, while co-management of physicians, nutritionists and psychologists were used in the observation group.The fasting blood glucose, 2 h postprandial blood glucose level, treatment compliance before delivery,self-management ability, pregnancy outcomes and neonatal outcomes were compared between the two groups.Results After the intervention, fasting blood glucose and 2 h postprandial blood glucose of the two groups were lower than those before the intervention, and the differences were statistically significant (P＜0.05).After intervention, there was no statistically significant difference in fasting blood glucose and 2 h postprandial blood glucose between the two groups (P＞0.05).The complete compliance rate and total compliance rate of the observation group were higher than those of the control group, and the non-compliance rate was lower than that of the control group, with statistically significant differences (P＜0.05).The scores of self-management attitude, diet compliance, exercise problems and blood glucose monitoring problems in the observation group were higher than those in the control group, with statistically significant differences (P＜0.05).The rate of natural delivery in the observation group was higher than that in the control group, and the rate of cesarean section was lower than that in the control group, with statistically significant differences (P＜0.05).The overall incidence of adverse pregnancy outcomes of puerperae in the observation group was lower than that in the control group, and the difference was statistically significant (P＜0.05).The overall incidence of adverse outcomes of newborn in the observation group was lower than that in the control group, and the difference was statistically significant(P＜0.05).Conclusion Co-management of physicians, nutritionists and psychologists for specific dietary arrangements,exercise guidance, psychological counseling and blood glucose control through Wechat platform, so as to improve the compliance and self-management ability of patients with gestational diabetes mellitus and effectively reduce maternal and infant complications.

Key words： Gestational diabetes Co-management of physicians, nutritionists and psychological consultant Blood glucose control Pregnancy outcome

引用本文:

刘艳丽；钟义春；陈晓正；何健敏；林慧卿；陈香华. 医师、营养师、心理咨询师共同管理对妊娠糖尿病患者血糖控制及妊娠结局的影响[J]. 中国当代医药, 2020, 27(8): 105-108转112.
LIU Yan-li； ZHONG Yi-chun； CHEN Xiao-zheng； HE Jian-min； LIN Hui-qing； CHEN Xiang-hua. Influence of co-management of physicians, nutritionists and psychologist on blood glucose control and pregnancy outcome in patients with gestational diabetes. 中国当代医药, 2020, 27(8): 105-108转112.

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