[1]李海鸿,李雪娇,周敏,等.家庭跟进式护理干预对妊娠糖尿病患者遵医行为及妊娠结局的影响[J].西部中医药,2019,32(04):130-133.
　LI Haihong,LI Xuejiao,ZHOU Min,et al.Effects of Family Follow-up Nursing Intervention on Compliance Behavior and Pregnancy Outcome of the Patients with Gestational Diabetes Mellitus[J].Western Journal of Traditional Chinese Medicine,2019,32(04):130-133.
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家庭跟进式护理干预对妊娠糖尿病患者遵医行为及妊娠结局的影响
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
32
期数:
2019年04期
页码:
130-133
栏目:
出版日期:
2019-04-15

文章信息/Info

Title:
Effects of Family Follow-up Nursing Intervention on Compliance Behavior and Pregnancy Outcome of the Patients with Gestational Diabetes Mellitus
文章编号:
1004-6852(2019)04-0130-04
作者:
李海鸿1，李雪娇1，周敏1，孟照琰1，张玲1，李晓娟2△
1 甘肃省妇幼保健院护理部，甘肃 兰州 730050； 2 甘肃省中医院
Author(s):
LI Haihong1, LI Xuejiao1, ZHOU Min1, MENG Zhaoyan1, ZHANG Ling1, LI Xiaojuan2△
1 Nursing Department, Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, China 2 Gansu Provincial Hospital of Traditional Chinese Medicine
关键词:
妊娠糖尿病; 家庭跟进式护理干预; 个体化医学营养治疗; 依从性
Keywords:
gestational diabetes mellitus;  family follow-up nursing intervention;  individualized medical nutrition therapy;  compliance
分类号:
R221
文献标志码:
B
摘要:
目的：观察家庭跟进式护理干预对妊娠糖尿病(GDM)患者医学营养治疗的依从性、妊娠结局、产后代谢指标及妊娠期人体成分的影响。方法：将303例GDM患者随机分为观察组和对照组，观察组154例，对照组149例。观察组通过家庭跟进式护理干预给予妊娠期及哺乳期全程个体化医学营养治疗（IMNT）干预：按照营养评估→协助医生制定IMNT计划→方案实施与电话跟踪随访→健康教育→IIMNT疗效监测和评估→协助医生动态调整IMNT方案6阶段循环式指导；对照组在来院复查时给予传统口头教育进行干预。观察2组妊娠结局及对胎儿的影响。结果:剖宫产率及妊娠高血压综合征、胎膜早破、羊水过多、羊水过少、先兆流产等并发症发生率2组比较，差异均有统计学意义（P＜0.05）。子痫前期的发生率2组比较，差异无统计学意义（P＞0.05）。胎儿出现低血糖、高胆红素血症及早产、巨大儿、胎儿窘迫的比例2组比较，差异有统计学意义（P＜0.05）。干预后 6个月时，糖化血红蛋白、空腹血糖、餐后2小时血糖、总胆红素、甘油三酯、血清总胆固醇、白蛋白、总蛋白等生化指标2组比较，差异有统计学意义（P＜0.05）；血红蛋白含量2组比较，差异无统计学意义（P＞0.05）。产后24～48小时产妇身体总水量、脂肪含量、体脂百分比、体质量、基础代谢率等2组比较，差异有统计学意义（P＜0.05）；去脂体质量、骨骼肌含量、腰臀围比值2组比较，差异无统计学意义（P＞0.05）。结论：运用家庭跟进式护理干预有助于提高GDM患者医学营养治疗的依从性，改善妊娠结局、产后代谢指标及妊娠期人体成分。
Abstract:
Objective：To observe the effects of family follow-up nursing intervention on therapeutic compliance behavior of medical nutrition, pregnancy outcome, postpartum metabolic indexes and body component during gestation period of the patients with gestational diabetes mellitus (GDM). Methods: All 303 GDM patients were randomized into 154 cases in the observation group and 149 cases in the control group, The observation group received individualized medical nutrition therapy (IMNT) intervention during the whole process of gestation period and lactation through family follow-up nursing intervention: six-phase cyclical guide including nutritional assessment→help the doctor establish IMNT regimen-regimen implementation and telephone tracking and follow-up→health education→clinical effects monitoring and assessment of IMNT→ help the doctor adjust IMNT regimen dynamically, the control group were intervened by traditional oral education when they reviewed. To observe pregnancy outcome and the influence on the fetus in both groups. Results: The difference had statistical meaning in the comparisons of the incidences of cesarean section, pregnancy-induced hyptertension syndrome, premature rupture of fetal membranes, hydramnios, hypamnion, threatened abortion and others (P＜0.05). The difference had no statistical meaning in the comparisons of the incidences of preeclampsia (P＞0.05). The difference was statistically significant in the comparisons of the ratios of the baby suffering hypoglycemia and hyperbilirubinemia, premature, giant baby and fetal distress (P＜0.05). In six months after the intervention, the difference had statistical meaning in the comparisons of biochemical indicators such as glycosylated hemoglobin, fasting blood glucose, 2hours postprandial blood glucose, total bilirubin, triglyceride, serum total cholesterol, albumin, total protein and others between both groups (P＜0.05); the difference had no statistical meaning in the comparisons of hemoglobin contents between both groups (P＞0.05). The difference was found in the comparisons of total body water of the puerperant, fat content, the percentage of body fat, body mass and basal metabolic rate from 24 hours to 48 hours after the delivery between both groups (P＜0.05); the difference had no statistical meaning in the comparisons of degreasing mass, skeletal muscle content, waist hip circumference ratio and others between both groups (P＞0.05). Conclusion: Family follow-up nursing intervention is helpful to improve therapeutic compliance behavior of medical nutrition, pregnancy outcome, postpartum metabolic indexes and body component during gestation period of GDM patients.

备注/Memo

备注/Memo:
收稿日期：2019-01-27 *基金项目：兰州市科学计划项目(编号2016-2-54)。 作者简介：李海鸿(1971—)，女，副主任护师，硕士研究生导师。研究方向：护理管理及围产期保健，妇产科疾病、妊娠代谢的护理。 △通讯作者：李晓娟(1971—)，女，副主任护师。研究方向：慢性病的管理及老年病的护理。
更新日期/Last Update: 2019-04-15