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目的观察实施综合管理改善妊娠糖尿病高危孕妇妊娠结局的效果。方法 2015年1月~2016年10月实施综合管理的妊娠糖尿病高危孕妇130例作为观察组,2013年1月~2014年12月未进行综合管理的140例妊娠糖尿病高危孕妇作为对照组,对照组进行常规孕前检查和指导,观察组实施综合管理干预,包括完善管理组织、加强心理支持、饮食保健指导、加强孕期保健指导、运动指导、密切监测、电话回访式。观察两组临床疗效。结果干预前,两组孕妇空腹血糖水平比较差异无统计学意义(P>0.05),分娩前,观察组空腹血糖水平为(5.88±0.48)mmol/L,低于对照组的(6.22±0.52)mmol/L(P<0.05);观察组遵医行为好为95.38%,高于对照组的62.86%(P<0.05);观察组孕妇并发症发生率为4.62%、胎儿不良结局发生率为5.38%、进展为妊娠糖尿病者为3.08%,低于对照组的11.43%、12.86%、9.29%(P<0.05)。结论对妊娠糖尿病高危因素孕妇实施综合管理的效果能够降低血糖水平,提高遵医行为,减少孕妇并发症及胎儿不良结局,减少妊娠糖尿病的发生。
Objective To observe the effect of integrated management on the improvement of pregnancy outcomes in high-risk pregnant women with gestational diabetes mellitus. Methods From January 2015 to October 2016, 130 pregnant women with gestational diabetes mellitus who underwent integrated management were enrolled in this study. 140 pregnant women with high-risk gestational diabetes without integrated management from January 2013 to December 2014 were selected as the control group, General pre-pregnancy examination and guidance, observation group implementation of integrated management intervention, including the improvement of management organizations, strengthen psychological support, diet health guidance, strengthen health guidance during pregnancy, exercise guidance, close monitoring, telephone interview. The clinical effects of two groups were observed. Results Before fasting, there was no significant difference in fasting plasma glucose between the two groups (P> 0.05). Before fasting, the fasting blood glucose level in the observation group was (5.88 ± 0.48) mmol / L, which was lower than that in the control group (6.22 ± 0.52) mmol / L (P <0.05). The compliance rate of the observation group was 95.38%, higher than 62.86% (P <0.05) of the control group. The incidence of complications in the observation group was 4.62%, and the incidence of fetal adverse outcomes was 5.38 %, The progress of gestational diabetes was 3.08%, lower than the control group of 11.43%, 12.86%, 9.29% (P <0.05). Conclusion The integrated management of pregnant women with high risk factors for gestational diabetes can reduce blood glucose levels, improve compliance, reduce complications of maternal complications and fetal unhealthy outcomes and reduce the incidence of gestational diabetes.