产科临床护理路径在妊娠期糖尿病孕妇中的应用效果

目的：探讨产科临床护理路径对妊娠期糖尿病孕妇的实施效果。方法选择妊娠期糖尿病孕妇80例，按照随机数字表法分为观察组和对照组各40例，观察组采用产科临床护理路径实施护理指导和管理，对照组则采用常规产科护理方法，比较两组孕妇健康教育达标、出院回访率与满意度、分娩方式、产后出血、母乳喂养、血糖控制等差异。结果观察组患者空腹血糖为（4．61±0．43）mmol/L，餐前30 min血糖为（4．21±0．89） mmol/L，餐后2 h 血糖为（6．22±0．21） mmol/L，凌晨血糖为（4．92±0．73）mmol/L，对照组分别为（5．72±3．20），（5．85±2．42），（7．68±2．95），（6．39±3．18）mmol/L，差异有统计学意义（t 值分别为2．1743，4．0226，3．1222，2．8495；P ＜0．05）。观察组剖宫产者13例（32．50％），对照组剖宫产者24例（60．00％），差异无统计学意义（χ2＝2．2052，P＞0．05）。观察组产后出血者2例（5．00％），母乳喂养者38例（95．00％）；对照组产后出血者12例（30．00％），母乳喂养者29例（72．50％），两组比较，差异有统计学意义（χ2值分别为8．6580，7．4397；P＜0．05）。观察组孕妇的依从性高于对照组，差异有统计学意义（ U＝2．9144，P＜0．01）；观察组孕妇健康教育达标率高于对照组，差异有统计学意义（χ2＝23．8095，P＜0．01）；观察组产后出院回访率高于对照组，差异有统计学意义（U＝2．8353，P＜0．01）。结论产科临床护理路径能明显提高糖尿病孕妇的血糖控制率，提高其满意度和依从性，具有较高的临床推广应用价值。

Application effect of clinical care path in pregnant women with gestational diabetes

Objective To investigate the value of clinical care path in pregnant women with gestational diabetes .Methods Eighty pregnant women with gestational diabetes were selected and randomly divided into the observation group （ n =40 ） and the control group （ n =40 ） .The observation group was carried out the clinical nursing care path, while the control group used the conventional care method .The results were presented by comparing the health education , patients ’ satisfaction, child delivery mode , postpartum hemorrhage , breastfeeding , and blood glucose control status .Results The fasting blood glucose , thirty minutes before and two hours after meal glucose , and the midnight glucose in the observation group were （4.61 ±0.43）, （4.21 ±0.89）, （6.22 ±0.21） and （4.92 ±0.73） mmol/L, respectively.Those in the control group were （5.72 ±3.20）, （5.85 ±2.42）, （7.68 ±2.95） and （6.39 ±3.18） mmol/L.The glucose values were significantly reduced （t=2.1743,4.022 6,3.122 2,2.849 5,respectively;P〈0.05）.Thirteen patients （32.50%） in the observation group and twenty-four patients （60.00%） in the control group were undergone cesarean section.There was no significant difference （χ2 =2.205 2,P〈0.05）.In the observation group, two patients （5.00%） had postpartum hemorrhage and thirty-eight patients （95.00%） took breast feeding; while in the control group, twelve patients （ 30.00%） had postpartum hemorrhage and twenty-nine patients （72.50%） took breast feeding.The differences were significant （χ2 =8.658 0,7.439 7,respectively;P〈0.05）.The compliance in the observation group was significantly higher than that in the control group （ U=2.914 4,P〈0.01）.And the passing rate of health education （χ2 =23.809 5,P〈0.01） and the re-visiting rate （U=2.835 3,P＆lt;0.01） in the observation group were also significantly higher than those in the control group.Conclusions Clinical care path can improve the nursing care treatment and patients ’