两种食物交换份法用于妊娠期糖尿病的比较  

Comparison of two kinds of food exchange lists in patients with gestational diabetes mellitus

作　　者：沈彩红[1] 施香颖[1] 李倩[1] 

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240

出　　处：《上海护理》2010年第2期17-20,共4页Shanghai Nursing

摘　　要：目的通过观察妊娠期糖尿病(GDM)孕妇采用食物交换份法(FEL)和基于血糖负荷概念的食物交换份法(GL+FEL)的接受程度、饮食行为改变,孕期血糖,体质指数和围生期结局的影响,比较两种方法在GDM孕妇治疗中的作用。方法选取2008年5月—2009年3月在我院产科门诊确诊为GDM的单胎孕妇80例,分为实验组42例和对照组38例。实验组采用(GL+FEL)法,对照组采用FEL,通过多种方式,实施至分娩结束,比较两种方法治疗前后孕妇体质量改变,空腹血糖(FBG),餐后2h血糖(2hPBG)和糖化血红蛋白(HbA1c)的变化及围生期结局。结果实验组FBG、2hPBG和HbA1c与对照组比较差异有统计学意义(P<0.05)。两组孕妇孕期体质量总增加量和每周体质量增加量间差别有统计学意义(P<0.05);两组新生儿出生体质量间差别无统计学意义(P>0.05);但巨大儿发生率实验组低于对照组,差异有统计学意义(P<0.05)。结论GL+FEI对GDM孕妇的饮食干预效果优于单FEL,对孕妇在孕期控制血糖、体重,防止围生期的不良反应,促进母婴安全,具有积极的促进作用。Objective To investigate the effects of food exchange list（FEL） and FEL based on glycemic load（GL＋FEL） on the acceptance,dietary behavior changes,blood glucose,body mass index and impact of perinatal outcome in patients with gestational diabetes mellitus（GDM）,and to compare their roles in the treatment of GDM.Methods Total 80 single pregnant women with GDM in our hospital obstetrics clinic from May 2008 to March 2009 were selected and randomly divided into the trial group（n=42,receiving GL＋FEL） and the control group（n=38,receiving FEL）,implemented through a variety of ways until to the delivery.The two kinds of food exchange lists were compared through body mass changes,fasting blood glucose（FBG）,2-hour postprandial blood glucose（2hPBG） and glycosylated hemoglobin（HbA1c） changes and perinatal outcome in GDM patients.Results FBG,2hPBG and HbA1C in the trial group were significantly decreased than those in the control group after treatment（P0.05）.There were significant differences in the total and weekly weight gain of GDM patients between the two groups（P0.05）,but there were no significant differences in newborns＇ body weight（P0.05）.The rate of macrosomia in the trial group was significantly lower than that in the control group（P0.05）.Conclusion GL＋FEL is better than FEL in dietary intervention for GDM patients,with active promotion in the control of blood glucose,and weight,prevention of adverse events during perinatal period,and maternal and child safety.

关 键 词：妊娠期糖尿病 食物交换份法 基于血糖负荷概念的食物交换份法 

分 类 号：R714.2[医药卫生—妇产科学] R587.1[医药卫生—临床医学]