中国妇幼保健

目的 探讨集中群组孕期保健模式对妊娠期糖尿病(gestational diabetes mellitus, GDM)孕妇妊娠结局的影响。方法 选取2022年6—12月在杭州市妇产科医院产科就诊的GDM孕妇110例，采用随机数字表法分为观察组(55例)和对照组(55例)。对照组给予常规GDM孕期保健健康宣教；观察组实施集中群组孕期保健管理模式。比较两组GDM孕妇干预前后的自我管理能力、血糖水平及妊娠结局。结果 干预后，观察组孕妇自我管理能力得分(114.20±10.08)分显著高于对照组的(95.07±9.69)分，差异有统计学意义(t=10.146,P<0.05);观察组孕妇的空腹血糖(FBG)水平(4.96±0.41)mmol/L、餐后2 h血糖(PBG)(5.95±0.54)mmol/L均低于对照组的(5.33±0.29)mmol/L、(6.48±0.39)mmol/L,差异均有统计学意义(t=5.463、5.901,均P<0.05),观察组GDM孕妇自然分娩率(89.09%)高于对照组(69.09%),差异有统计学意义(χ²=5.095,P<0.05)。观察组妊娠期高血压(3.64%)、巨大儿(1.82%)、新生儿低血糖(1.82%)发生率均低于对照组(16.36%、14.55%、12.73%),差异均有统计学意义(χ²=3.884、5.920、5.356,均P<0.05)。结论 集中群组式保健模式能提高GDM孕妇的自我管理及血糖控制水平，改善母婴结局。

Objective To explore the influence of concentrated group pregnancy health care mode on the pregnancy outcome of pregnant women with diabetes.Methods 110 patients with GDM who were hospitalized in Hangzhou Obstetrics and Gynecology Hospital from June 2022 to December 2022 were selected as the study subjects.They were divided into observation group and control group with 55 patients in each group by random number table.The control group was given routine GDM health education; The observation group implemented the centralized group pregnancy health care management mode.The blood glucose control level and pregnancy outcome were compared between the two groups before and after intervention.Results After intervention, the score of self-management ability of pregnant women in the observation group(114.20±10.08) was significantly higher than that in the control group(95.07±9.69), the difference was statistically significant(t=10.146,P<0.05); The FBG level(4.96±0.41) mmol/L,PBG(5.95±0.54) mmol/L of pregnant women in the observation group were lower than those in the control group(5.33±0.29) mmol/L,PBG(6.48±0.39) mmol/L,and the difference was statistically significant(t=5.463,5.901,P<0.05).The rate of spontaneous delivery in GDM in the observation group(89.09%) was higher than that in the control group(69.09%),and the difference was significant(χ²=5.095,P<0.05).The incidence of gestational hypertension(3.64%),macrosomia(1.82%) and neonatal hypoglycemia(1.82%) were lower in the observation group(16.36%,14.55%,12.73%),with the statistically significant difference(χ²=3.884,5.920,5.356,P<0.05).Conclusion Centralized cluster health care mode can effectively improve the self-management ability of GDM patients, improve the blood glucose control level, and improve the maternal and infant outcomes.