目的探讨早期个案管理对妊娠期糖尿病患者血糖控制及妊娠结局的影响。方法选择妊娠期糖尿病患者126例,随机分为试验组和对照组各63例,对照组给予常规护理,试验组给予早期个案管理,比较两组患者血糖水平、妊娠相关临床指标、妊娠结局、围产儿健康状况与满意度的差异。结果试验组患者干预后的空腹血糖、三餐后2 h血糖与睡前血糖均低于对照组,差异有统计学意义(P <0. 05);分娩前体重、孕期增长体重、BMI、羊水指数、阴道炎发生率均低于对照组,差异有统计学意义(P <0. 05);发生高血压、胎盘前置、羊水过多、剖宫产、胎儿窘迫、新生儿窒息、低血糖、巨大儿与高胆血红素血症的概率均低于对照组,差异有统计学意义(P <0. 05);护理满意度优于对照组,差异有统计学意义(P <0. 05)。结论早期个案管理能有效改善妊娠期糖尿病患者的血糖水平和妊娠结局,值得临床推广应用。

Objective To explore the effect of early case management on blood glucose control and pregnancy outcome in patients with gestational diabetes mellitus(GDM). Methods A total of 126 patients with GDM were randomly divided into experimental group and control group,63 cases in each group. The control group was given routine nursing care and the experimental group was given early case management. The differences of blood sugar level,pregnancy-related clinical indicators,pregnancy outcome,perinatal health status and satisfaction between the two groups were compared. Results The fasting blood glucose,2 h postprandial blood glucose after three meals and pre-sleep blood glucose of the experimental group were lower than those of the control group,there were statistical significances(P < 0. 05). Weight before delivery,the degree of weight gain during pregnancy,BMI,amniotic fluid index,the incidence of vaginitis of the experimental group were lower than those of the control group,there were statistical significances(P <0. 05). The incidences of hypertension,placenta previa,excessive amniotic fluid,cesarean section,fetal distress,neonatal asphyxia,neonatal hypoglycemia,macrosomia and hyperbilirubinemia of the experimental group were lower than those of the control group,there were statistical significances(P < 0. 05). The nursing satisfaction of the experimental group was better than that of the control group,there was statistical significance(P < 0. 05). Conclusion Early case management can effectively control the blood sugar level and improve the pregnancy outcome of patients with GDM,which is worthy for clinical application.