探究区域医联体MDT模式对围产期妇女营养干预及妊娠结局的影响  

The effects of regional medical conjoined MDT model on nutrition intervention and pregnancy outcome of perinatal women

作　　者：房莹 田丽槟 林萱 徐嘉蔚 杨华 景丽丽 吴清明 FANG Ying;TIAN Libin;LIN Xuan;XU Jiawei;YANG Hua;JING Lili;WU Qingming(School of Public Health,Wuhan University of Science and Technology,Wuhan 430080,China;Department of Endocrinology,China Resources Wisco General Hospital,Wuhan 430080,China;Department of Obstetrics and Gynecology,China Resources Wisco General Hospital,Wuhan 430080,China;Department of Clinical Medicine,School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China;Maternal and Child Health Care Department,Qingshan Maternal and Child Health Care Hospital,Wuhan 430080,China)

机构地区：[1]武汉科技大学医学院公共卫生学院,湖北武汉430080 [2]华润武钢总医院内分泌科,湖北武汉430080 [3]华润武钢总医院妇产科,湖北武汉430080 [4]武汉科技大学医学院临床医学系,湖北武汉430065 [5]武汉市青山区妇幼保健院孕产保健部,湖北武汉430080

出　　处：《西部医学》2023年第9期1363-1367,共5页Medical Journal of West China

基　　金：湖北省卫生健康委员会面上项目(WJ2019M001)。

摘　　要：目的探究区域医联体MDT模式对围产期妇女营养干预及妊娠结局的影响。方法选取2019年1月—4月首次在青山区妇幼保健院或华润武钢总医院妇产科门诊建卡行产前检查的663例围产期妇女,按其是否自愿参与的意愿分为对照组281例和观察组382例。对照组采用传统孕妇孕期营养、体重管理模式,观察组采用区域医联体MDT模式对孕妇孕期进行营养干预,对比两组患者GWG,分娩前BMI、分娩方式、并发症发生率(产后大出血、产程阻滞、妊娠糖尿病、妊娠期间高血压)以及Apgar评分。结果分娩前观察组孕妇食物GWG、分娩前BMI、FPG、TC低于对照组(P<0.05);观察组Hb、血清钙、血清铁高于对照组(P<0.05);观察组孕妇自然流产、早产儿、巨大儿的发生率低于对照组(P<0.05),两组孕妇低体重儿、死胎的发生率差异无统计学意义(P>0.05);观察组孕妇GDM、妊娠期高血压、妊娠期肝内胆汁郁积症、孕前羊水过多、产后出血的发生率低于观察组(P<0.05),观察组新生儿的Apgar评分高于对照组,差异有统计学意义(P<0.05)。结论区域医联体MDT模式对围产期妇女进行营养干预有益于降低妊娠期并发症发生。Objective To explore the effects of regional medical conjoined MDT model on nutrition intervention and pregnancy outcome of perinatal women.Methods A total of 663 perinatal women who underwent their first prenatal examination in Maternal and Child Health Care Hospital or the department of Obstetrics and Gynecology of China Resources Wisco General Hospital,from January 2019 to April 2019 were divided into the control group and the observation group according to their willingness to participate,including 281 cases in the control group and 382 cases in the observation group.Control group using traditional pregnant women during pregnancy nutrition,weight management pattern,the regional medical couplet body MDT pattern on the observation group of pregnant women prenatal nutrition intervention,compared two groups of patients with pregnancy GWG,BMI before delivery,delivery mode and complications(block,the stages of Postpartum hemorrhage,gestational diabetes,high blood pressure during pregnancy)and Apgar score.Results GWG,BMI,FPG and TC of pregnant women in the observation group before delivery were lower than those in the control group(P<0.05).The levels of the above indexes in the observation group were(13.49±3.01)kg,(26.75±1.64)kg/m 2,(4.82±0.86)mmol/L,(2.82±1.04)mmol/L,Lower than that of control group(15.63±3.46)kg,(27.56±2.37)kg/m 2,(7.37±0.69)mmol/L,(6.53±0.78)mmol/L(P<0.05).Hemoglobin,serum calcium and serum iron in the observation group were higher than those in the control group(P<0.05).The levels of the above indexes in the observation group were(117.13±9.24)g/L,(1.76±0.23)mmol/L and(7.89±0.24)mmol/L,respectively,higher than that of control group(108.75±12.21)g/L,(1.51±0.46)mmol/L,(7.10±0.76)mmol/L(P<0.05).The incidence of spontaneous abortion,premature birth and macrosomia in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of low birth weight,neonatal malformation and stillbirth between the two groups(P>0.05).The incidenc

关 键 词：医联体 MDT 围产期 营养干预 妊娠结局 

分 类 号：R714.1[医药卫生—妇产科学]