CAJ | 학술논문

目的：探讨妊娠期糖尿病( GDM)“一日门诊”后延续护理的效果。方法选取2013年5—9月在北京大学第一医院产科参加妊娠期糖尿病“一日门诊”并分娩的妊娠期糖尿病孕妇354例，“一日门诊”结束后根据是否自愿参加延续护理干预分为两组，未参加干预的为对照组183例，参加干预的为干预组171例。采用重复测量方差分析比较两组不同随访时期的空腹血糖及餐后2 h血糖值是否有统计学差异。结果干预组和对照组的剖宫产率分别为48.5%(83/171)和49.7%(91/183)，巨大儿发生率分别为9.4%(16/171)和12.0%(22/183)，两组比较差异无统计学意义(P>0.05)。干预组在随访前、随访中、末次随访3个时间点空腹血糖值及餐后2h血糖均低于对照组，差异均有统计学意义( P<0.05)。结论妊娠期糖尿病“一日门诊”延续护理能有效降低GDM产妇的血糖水平，但对控制GDM产妇的妊娠期体质量增长、降低剖宫产率及巨大儿发生率的效果不显著。
목적：탐토임신기당뇨병( GDM)“일일문진”후연속호리적효과。방법선취2013년5—9월재북경대학제일의원산과삼가임신기당뇨병“일일문진”병분면적임신기당뇨병잉부354례，“일일문진”결속후근거시부자원삼가연속호리간예분위량조，미삼가간예적위대조조183례，삼가간예적위간예조171례。채용중복측량방차분석비교량조불동수방시기적공복혈당급찬후2 h혈당치시부유통계학차이。결과간예조화대조조적부궁산솔분별위48.5%(83/171)화49.7%(91/183)，거대인발생솔분별위9.4%(16/171)화12.0%(22/183)，량조비교차이무통계학의의(P>0.05)。간예조재수방전、수방중、말차수방3개시간점공복혈당치급찬후2h혈당균저우대조조，차이균유통계학의의( P<0.05)。결론임신기당뇨병“일일문진”연속호리능유효강저GDM산부적혈당수평，단대공제GDM산부적임신기체질량증장、강저부궁산솔급거대인발생솔적효과불현저。
Objective To explore the effects evaluation of extended care after “one-day care” for delivery women with gestational diabetes mellitus ( GDM ) . Methods From May to September 2013 in Department of Gynaecology and Obstetrics Peking University First Hospital, a total of 354 GDM pregnant women participated “one-day care” and then they were divided into experimental group (171 cases) and control group (183 cases) according to whether attended the extended care. Using repeated variance analysis measurement, the fasting blood glucose and postprandial 2h blood glucose values were compared whether the values had statistical significance between two groups at different visit time. Results The uterine-incision rates were 48. 55%(83/171) and 49. 7%(91/183) in the experimental group and control group respectively, and the incidence of giant babies were 9. 4%(16/171) and 12. 0%(22/183) respectively in the experimental group and control group (P>0. 05). The time point of before visit, during visit and last visit in the experimental group, the fasting blood glucose and postprandial 2 h blood glucose were lower than that of the control group (P<0. 05). Conclusions “One-day care” for GDM can reduce the blood glucose level of GDM delivery women, but it has not significant effects on the control of gestation′s body weight and to decline the uterine-incision rate and incidence of giant babies.