目标导向性健康宣教结合个性医学营养疗法对GDM患者产后糖脂代谢转归的影响  

Effects of the goal-directed health promotion combined with the personalized medical nutrition therapy for pregnant women with gestational diabetes mellitus on their postnatal glucose-lipid metabolism prognosis

作　　者：韦秀菊 李智敏[1] 江燕 覃秀 曾群群 WEI Xiuju;LI Zhimin;JIANG Yan;QIN Xiu;ZENG Qunqun(Xiaolan People's Hospital of Zhongshan(The Fifth People's Hospital of Zhongshan),Zhongshan,Guangdong Province,644600)

机构地区：[1]广东省中山市小榄人民医院,中山市第五人民医院,528415

出　　处：《中国计划生育学杂志》2024年第12期2841-2846,共6页Chinese Journal of Family Planning

摘　　要：目的:观察目标导向性健康宣教结合个性医学营养疗法对妊娠期糖尿病(GDM)患者产后糖脂代谢转归的影响。方法:选取2021年2月-2023年5月就诊于本院妇产科的60例采用目标导向性健康宣教+个性医学营养疗法干预的GDM患者作为目标组,采用常规健康教育+个性医学营养疗法干预的GDM患者60例作为常规组。评估两组干预前后行为改变评分变化,统计两组妊娠不良结局总发生率,检测干预前与产后12周糖脂代谢、胰岛功能水平。结果:两组干预后自我体重管理、饮食控制、适量运动评分均升高且目标组评分高于常规组,妊娠不良结局总发生率目标组(3.3%)低于常规组(13.3%)(均P<0.05)。产后12周,两组空腹血糖、餐后1h和2h血糖、糖化血红蛋白均降低且目标组(5.01±0.44mmol/L、7.20±0.51mmol/L、6.67±0.43mmol/L、5.64%±0.59%)均低于常规组(5.54±0.63mmol/L、7.94±0.69mmol/L、7.38±0.51mmol/L、6.27%±0.74%),两组高密度脂蛋白胆固醇、胰岛β细胞功能指数均升高且目标组(1.64±0.28mmol/L、64.01±7.73)高于常规组(1.39±0.26mmol/L、56.85±6.84),两组甘油三酯(TG)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)均降低且目标组(1.15±0.22 mmol/L、4.35±0.58mmol/L、2.18±0.32、2.98±0.72mmol/L)低于常规组(1.49±0.31mmol/L、4.63±0.67mmol/L、2.64±0.37、3.34±0.81mmol/L)(均P<0.05)。结论:目标导向性健康宣教结合个性医学营养疗法可有效促进GDM患者行为改变,减少妊娠不良结局发生,改善产后糖脂代谢及胰岛功能水平。Objective:To observe the effects of the goal-directed health promotion combined with the personalized medical nutrition therapy for pregnant women with gestational diabetes mellitus(GDM)on the postnatal glucose-lipid metabolism prognosis.Methods:6o pregnant women with GDM were given the goal-oriented health education combined with the personalized medical nutrition therapy intervention were selected in the study group,and another 60 pregnant women with GDM were given the conventional health education combined with the personalized medical nutrition therapy intervention were selected in the control group from February 2021 to May 2023.The scores of the behavioral change of the women in the two groups before and after intervention were assessed.The total incidence of the adverse pregnancy outcomes of the women in the two groups was counted.The levels of the glucose and lipid metabolism and the pancreatic islet function of the women in the two groups before intervention and in the postpartum 12th weeks were detected.Results:After intervention,the scores of the self-weight management,the diet control and the moderate exercise of the women in the two groups had increased significantly,and which of the women in the study group were significantly higher than those of the women in the control group.The total incidence of the adverse pregnancy outcomes(3.3%)of the women in the study group was significantly lower than that(13.3%)of the women in the control group(all P<0.05).In the postpartum 12th week,the levels of the fasting blood glucose and the lh and 2h postprandial blood glucose,and the glycosylated hemoglobin value of the women in the two groups had decreased significantly,and which(5.01±0.44 mmol/L,7.20±0.51 mmol/L,6.67±0.43 mmol/L and 5.64%±0.59%)of the women in the study group were significantly lower than those(5.54±0.63 mmol/L,7.94±0.69 mmol/L,7.38±0.51 mmol/L and 6.27%±0.74%)of the women in the control group.The high-density lipoprotein cholesterol and the pancreatic isletβ-cell function index of the

关 键 词：妊娠期糖尿病 目标导向性健康宣教 个性医学营养疗法 糖脂代谢 不良妊娠结局 

分 类 号：R473.71[医药卫生—护理学]