妊娠糖尿病患者应用瞬感扫描式葡萄糖监测系统改善孕期体重增长及生活质量的研究  

Improvement of weight gain and life quality with Free-Style Libre Flash Glucose Monitoring System in women with gestational diabetes mellitus

作　　者：蒋娅[1] 谢翠华[1] 李景香[1] 许文伟[1] 孟敏[1] 罗祥蓉[1] 王玲[1] 易慕辉 潘娟 许丽娴 Jiang Ya;Xie Cuihua;Li Jingxiang;Xu Wenwei;Meng Min;Luo Xiangrong;Wang Ling;Yi Muhui;Pan Juan;Xu Lixian(Department of Endocrinology and Metabolism,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Overseas Chinese Benefits,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Endocrinology and Metabolism,Qifu Hospital,Guangzhou University of Traditional Chinese Medicine,Guangzhou 511495,China;Department of Endocrinology and Metabolism,Panyu Central Hospital,Guangzhou 511402,China)

机构地区：[1]南方医科大学南方医院内分泌代谢科,广州510515 [2]南方医科大学南方医院惠侨科,广州510515 [3]广州中医药大学祈福医院内分泌代谢科,广州511495 [4]广州市番禺中心医院内分泌代谢科,511402

出　　处：《中华现代护理杂志》2019年第31期4046-4051,共6页Chinese Journal of Modern Nursing

基　　金：南方医科大学南方医院院长基金(2017H003);广东省自然科学基金博士启动项目(N0.2016A030310397)。

摘　　要：目的 探讨妊娠糖尿病患者应用瞬感扫描式葡萄糖监测系统对孕期体重增长及生活质量的影响.方法 2017年8月-2019年1月选择在广州市某3家三甲医院内分泌科确诊的妊娠糖尿病患者, 根据血糖监测意愿分为观察组39例和对照组43例.观察组使用瞬感扫描式葡萄糖监测系统(每14天更换一次传感器)结合指尖血糖监测,要求传感器识别为低血糖时必须监测指尖血糖对比,其余监测点孕妇可选择性监测空腹和餐后血糖.对照组患者入组后仅采用指尖血糖监测(至少监测2次/d,包括空腹和餐后2 h血糖).两组患者均根据血糖监测结果进行饮食、运动等自我管理指导,纳入微信管理,指导一日生活日志记录方法.在研究开始及随访第2周使用WHO-5幸福感指数量表调查两组患者幸福感指数得分;妊娠结束,记录患者围产期平均血糖水平、低血糖事件发生情况,以及不同BMI患者孕期体重增长合格率.结果 第2周时,观察组患者幸福感指数得分高于对照组,差异有统计学意义(P=0.037).观察组患者采用不同血糖监测方式的空腹及餐后2 h葡萄糖差异无统计学意义(P>0.05);两组患者孕期血糖控制(空腹及餐后2 h)水平差异无统计学意义(P>0.05),但观察组患者对低血糖的检出率高于对照组,差异有统计学意义(P=0.042).至妊娠结束,分层分析显示孕前BMI在18.5~24.9 kg/m^2的观察组患者体重增长合格率高于对照组,差异有统计学意义(P=0.035).结论 妊娠糖尿病患者使用瞬感扫描式葡萄糖监测系统使孕期体重控制更合理,且全程无痛,提高患者幸福感指数.Objective To investigate the gestational weight gain and quality of life in women with gestational diabetes mellitus(GDM) who used Free-Style Libre Flash Glucose Monitoring System. Methods From August of 2017 to January of 2019, the GDM patients diagnosed in the Department of Endocrinology in 3 ClassⅢ Grade A hospitals in Guangzhou were selected and divided into the observation group(n=39) and control group(n=43) according to their glucose monitoring willingness. The Free-Style Libre Flash Glucose Monitoring System was used for the observation group(sensor changed every 14 days) combined with the fingertip blood glucose monitor, it was necessary to monitor fingertip blood glucose contrast when hypoglycemia was identified by sensors. Pregnant women at other monitoring points could selectively monitor fasting and postprandial blood glucose. In the control group, after assigned into the group patients only monitored their fingertip blood glucose(at lease 2 times/d, including fasting and 2h postprandial blood glucose). The two groups were all instructed by self-management on diet, exercise etc according to the result of blood glucose monitor, the Wechat management was included to instruct them of the daily life diary recording method. World Health Organization-5 Well-Being Index (WHO-5) was adopted at the beginning of the study and the second week of follow-up to investigate the well-being index score of the patients in the two groups;at the end of pregnancy, the average perinatal blood sugar level, incidence of hypoglycemia events and the eligible rate of weight gain in different BMI patients were recorded. Results At the 2nd week, the score of well-being index in the observation group was higher than that in the control group with statistical significance(P=0.037).There was no statistically significant difference in fasting and 2 h postprandial glucose between the two groups (P>0.05). There was no significant difference in blood sugar control (fasting and 2 hours after meal) between the two groups (P>0.05), but t

关 键 词：糖尿病 妊娠 生活质量 体重控制 幸福感指数 血糖监测 瞬感扫描式葡萄糖监测系统 

分 类 号：R47[医药卫生—护理学]