移动医疗用于妊娠期糖尿病规范化管理的效果  

Effect of Mobile Health for Standardized Management on Womenwith Gestational Diabetes Mellitus

作　　者：黄菲玲 胡惠英[1] 张素菡 李瓅 张莉 陈小霞 张楚辞 钟红秀 姚爱民 刘翠英[8] 张宁芝[9] 薛小文 马良坤[1] HUANG Feiling;HU Huiying;ZHANG Suhan;LI Li;ZHANG Li;CHEN Xiaoxia;ZHANG Chuci;ZHONG Hongxiu;YAO Aimin;LIU Cuiying;ZHANG Ningzhi;XUE Xiaowen;MA Liangkun(Department of Obstetrics and Gynecology,PUMC Hospital,CAMS and PUMC,National Clinical Research Center for Obstetrics and Gynecology,Beijing 100730,China;Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Department of Obstetrics and Gynecology,Shenyang Maternity and Child Health Hospital,Shenyang 110014,China;Department of Women’s Health Care,Quanzhou Women’s and Children’s Hospital,Quanzhou,Fujian 362000,China;Department of Endocrinology,Shenyang Women’s and Children’s Hospital,Shenyang 110011,China;Department of Obstetrics and Gynecology,Xiamen Maternal and Child Health Hospital,Xiamen,Fujian 361003,China;Department of Obstetrics and Gynecology,Shunyi Women’s and Children’s Hospital of Beijing Children’s Hospital,Beijing 101300,China;Department of Obstetrics and Gynecology,Jinan Maternity and Child Care Hospital,Jinan 250001,China;Department of Obstetrics and Gynecology,Fuyang People’s Hospital,Fuyang,Anhui 236004,China;Department of Obstetrics and Gynecology,Beijing Pinggu Hospital,Beijing 101200,China)

机构地区：[1]国家妇产疾病临床研究中心中国医学科学院北京协和医学院北京协和医院妇产科,北京100730 [2]郑州大学附属郑州中心医院妇产科,郑州450007 [3]沈阳市妇幼保健院妇产科,沈阳110014 [4]泉州市妇幼保健院妇女保健科,福建泉州362000 [5]沈阳市妇婴医院内分泌科,沈阳110011 [6]厦门市妇幼保健院妇产科,福建厦门361003 [7]北京市顺义区妇幼保健院妇产科,北京101300 [8]济南市妇幼保健院妇产科,济南250001 [9]阜阳市人民医院妇产科,安徽阜阳236004 [10]北京市平谷区医院妇产科,北京101200

出　　处：《中国医学科学院学报》2021年第4期551-557,共7页Acta Academiae Medicinae Sinicae

基　　金：北京市科技计划项目(Z161100000516117)。

摘　　要：目的探讨移动医疗平台用于妊娠期糖尿病(GDM)孕妇规范化管理的效果。方法采用随机对照试验的研究方法,纳入295例GDM孕妇,计算机生成随机数字将受试者随机分为传统管理组和移动医疗管理组。传统管理组实行GDM规范化管理,移动医疗管理组在传统管理的基础上辅以移动医疗管理。记录并比较两组孕妇血糖控制情况,以及低出生体重儿、巨大儿、早产、胎膜早破、产后出血、新生儿窒息、畸形、分娩方式和新生儿转归等差异。结果移动医疗管理组孕妇血糖控制合格率优于传统管理组[(67.22±22.76)%比(60.69±21.28)%],差异有统计学意义(P=0.004)。两组低出生体重儿、巨大儿、早产、胎膜早破、产后出血、新生儿窒息、畸形、分娩方式和新生儿转归差异均无统计学意义(P均>0.05)。结论移动医疗用于GDM规范化管理可提高GDM孕妇的血糖控制率,但并未改善妊娠结局。由于干预时间较短,移动医疗对妊娠结局的改善作用仍需进一步研究。Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM).Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups.Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group[(67.22±22.76)%vs.(60.69±21.28)%,P=0.004].The incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit demonstrated no significant differences between groups(all P>0.05).Conclusions Mobile health applied in standardized management is conducive to the glycemic control of GDM women,whereas it does not significantly improve the pregnancy outcomes.Due to the short time of intervention,the effects of mobile health on pregnancy outcomes need further study.

关 键 词：移动医疗 妊娠期糖尿病 血糖控制 规范化管理 

分 类 号：R714.256[医药卫生—妇产科学]