妊娠期糖尿病患者心理健康状况的临床调查

目的:探讨妊娠期糖尿病(GDM)孕妇心理健康状况。方法:采用自制问卷调查表、状态-特质焦虑问卷(STAI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)等,对180名GDM孕妇及186名正常孕妇进行评定和对照研究,病例组同时抽取静脉血进行空腹血糖、餐后2 h血糖及糖化血红蛋白测定。结果:①GDM孕妇焦虑、抑郁发生率均较高,焦虑分值明显高于对照组,差异有统计学意义。②病例组组内分析结果表明高特质焦虑患者的糖化血红蛋白水平明显高于低特质焦虑患者的糖化血红蛋白水平。③对GDM患者心理状态产生影响的相关因素依次为缺乏糖尿病相关知识、担心母婴健康、控制饮食感到困难、血糖监测麻烦且痛苦、注射胰岛素感到恐惧不安、治疗费用高、时间长等。结论:①GDM患者有一定的焦虑与抑郁症状,尤焦虑症状明显,应引起重视。②特质焦虑可能在GDM患者的糖代谢控制中起着较为重要的作用。③GDM患者不良心理状态是多种因素综合作用的结果,需根据相关因素为其提供针对性的健康教育及综合性的心理支持。

The clinical investigation of mental health status of the patients of GDM

Objective:To explore the mental health status of the pregnant women with GDM.Methods:The value and control study were conducted on 180 pregnant women with GDM and 186 health pregnant women by self-made questionnaire,State-Trait Anxiety Inventory(STAI),Self-Rating Anxiety Scale(SAS),Self-Rating Depressive Scale(SDS) and so on.Venous fasting blood glucose and blood glucose 2 hours after meal and glycosylated hemoglobin were detected in the study group at the same time.Results:①The incidence of anxiety and depression were both significantly higher in pregnant women with GDM,especially the former,compared with those of the control group.②The analysis results in the study group showed much higher level of the glycosylated hemoglobin in the patients with high degree of status of anxiety than those with low ones.③The relative factors affecting the mental status of patients of GDM in turn were lack of relative knowledge of GDM,worry about the health of maternal and infant,difficulty of diet control,trouble and horrible monitoring of blood glucose,fear for injection of insulin,high cost and long duration for treatments and so on.Conclusion:①There are some symptoms of anxiety and depression in the patients of GDM,especially the former,which should be paid attention to.②The degrees of status of anxiety maybe play a more important role in the control of glucose metabolism in the patients of GDM.③The mental status of the pregnant women with GDM are the result of multiple factors,and specified health care education and combined mental supports should be available to individuals according to the relative factors.