CAJ | 학술논문

　　目的探讨如何建立妊娠期糖尿病的社区管理模式。方法进行前瞻性研究，在2011年9月~2012年9月到海珠区妇幼保健院和南方医科大学珠江医院产检的所有孕妇中抽取3000名20岁以上常住孕妇，筛查出糖尿病孕妇544例。分成两组，观察组（300例）由医院和社区联合管理，对照组（244例）按照传统的医院产检方法管理。比较两组的妊娠结局。结果在妊娠合并症方面：观察组妊娠期高血压疾病、羊水过多、早产、产后出血的发生率均低于对照组（P＜0.05），而羊水过少、胎膜早破，两组的差异无统计学意义（P＞0.05）；在围产儿预后方面：观察组巨大儿、低出生体重、新生儿低血糖发生率明显低于对照组（P＜0.05），胎儿生长受限、胎死宫内、胎儿窘迫、新生儿窒息、新生儿畸形发生率两组差异无统计学意义（P＞0.05）。结论医院结合社区卫生服务中心联合管理妊娠期糖尿病孕妇，可进一步减少糖尿病孕妇及围生儿并发症。
　　목적탐토여하건립임신기당뇨병적사구관리모식。방법진행전첨성연구，재2011년9월~2012년9월도해주구부유보건원화남방의과대학주강의원산검적소유잉부중추취3000명20세이상상주잉부，사사출당뇨병잉부544례。분성량조，관찰조（300례）유의원화사구연합관리，대조조（244례）안조전통적의원산검방법관리。비교량조적임신결국。결과재임신합병증방면：관찰조임신기고혈압질병、양수과다、조산、산후출혈적발생솔균저우대조조（P＜0.05），이양수과소、태막조파，량조적차이무통계학의의（P＞0.05）；재위산인예후방면：관찰조거대인、저출생체중、신생인저혈당발생솔명현저우대조조（P＜0.05），태인생장수한、태사궁내、태인군박、신생인질식、신생인기형발생솔량조차이무통계학의의（P＞0.05）。결론의원결합사구위생복무중심연합관리임신기당뇨병잉부，가진일보감소당뇨병잉부급위생인병발증。
Objective To explore how to establish community management model of gestational diabetes mellitus. Methods A prospective study was performed in 544 pregnant women with diabetes who come from HaiZhu Women and Children hospital and ZhuJiang Hospital of Southern Medical University from September 2011 to September 2012. All pregnant women with diabetes were divided into observation group (n=300) and control groups(n=244)randomly.The patients in observation group received hospitals and community joint management and those in control group received traditional methods. The pregnancy outcome of two groups was compared. Results In the pregnancy complications,the incidence rate of gestational hypertension, polyhydramnios,premature delivery and postpartum hemorrhage in observation group were lower than the control group(P < 0.05).In contrast,the incidence rate of oligohydramnios and premature rupture of membrane were not different between two groups (P > 0.05).In the perinatal prognosis,the incidence rate of fetal macrosomia, low birth weight and neonatal hypoglycemia in observation group were significantly reduced compared with control group (P < 0.05),but the incidence rate of fetal growth restriction,intrauterine fetal death,fetal distress,neonatal asphyxia and neonatal congenital malformation between two groups had no significant differences(P>0.05). Conclusion The management of gestational diabetes combined with hospital and community health service center can reduce the complications of diabetic pregnant women and perinatal infant.