健康管理课程对妊娠期糖尿病孕妇生活方式及妊娠结局的影响

目的 探讨健康管理课程干预对妊娠期糖尿病孕妇生活方式及妊娠结局的影响。方法 选取吉林省某三级甲等医院120例初次诊断为妊娠糖尿病孕妇，随机分实验组和对照组均60例，在常规治疗基础上，实验组实施健康管理干预，对照组采用常规妊娠健康指导。比较两组生活方式改变和妊娠结局情况。结果 入组8周后，实验组健康生活方式各维度得分及总均分高于对照组, 具有统计学意义 (P<0.05) ；产后1周，实验组生活方式总分及各维度得分明显高于对照组，存在分组效应和时间效应，具有统计学意义（P<0.05）。在妊娠结局中，实验组母体孕期感染 、羊水过多、产后出血、胎膜早破、酮症酸中毒、子痫的发生率明显低于对照组，具有统计学意义（P<0.05）；实验组围生儿中巨大儿、早产儿、胎儿宫内窘迫、新生儿窒息、新生儿低血糖发生率也明显低于对照组，具有统计学意义（P<0.05）。结论 健康管理课程能促进妊娠期糖尿病孕妇向健康生活方式转变，降低不良妊娠结局发生。

Effect of health management courses on lifestyle and pregnancy outcome of pregnant women with gestational diabetes

To investigate the effect of health management course intervention on the lifestyle and pregnancy outcome of pregnant women with gestational diabetes. Methods 120 pregnant women who were initially diagnosed with gestational diabetes in a grade III － A hospital in Jilin Province were randomly divided into experimental group and control group. On the basis of conventional treatment，the experimental group implemented health management interventions，while the control group used conventional pregnancy health guidance. Lifestyle changes and pregnancy outcomes were compared between the two groups. Ｒesults After 8 weeks of enrollment，the scores and total average scores of healthy lifestyles in the experimental group were higher than those in the control group，which was statistically significant ( P ＜ 0. 05) . A week after delivery，the total score of lifestyle and score of each dimension in the experimental group were significantly higher than those in the control group，and the grouping effect and time effect were statistically significant ( P ＜ 0. 05) . In pregnancy outcome，the incidences of maternal infection during pregnancy，polyhydramnios，postpartum hemorrhage，premature rupture of membranes，ketoacidosis and eclampsia in the experimental group were significantly lower than those in the control group ( P ＜ 0. 05) . The incidences of macrosomia，premature infants，fetal distress，neonatal asphyxia and neonatal hypoglycemia in the experimental group were also significantly lower than those in the control group ( P ＜ 0. 05) . Conclusion Health management course can promote pregnant women with gestational diabetes to change healthy lifestyle and reduce adverse pregnancy outcome.