|关键词||妊娠期糖尿病 一日营养门诊 医学营养治疗 实践模式|
|其他题名||The analysis of the effects of “one-day Nutrition Clinic for GDM” practice|
方法：采用类实验性研究方法，方便抽样选取2013年6月至2013年10月在北京某三甲综合医院产科建档规律产检、确诊为GDM并于此院分娩的88例孕妇为历史对照组， 2014年6月至2014年10月在该产科建档规律产检、确诊为GDM并于此院分娩的51例孕妇为实验组。对实验组进行GDM一日营养门诊干预，与接受常规产检医生的口头营养指导的历史对照组进行妊娠结局比较，对数据采用spss 16.0进行分析。另外，采用访谈法，了解实验组孕妇及产科门诊医生对GDM一日营养门诊的接受度和存在的问题，对访谈资料进行类属分析，归纳、提炼主题。
Objective: To analyze the effects of “one-day Nutrition Clinic for GDM” practice, discuss the issues found in the new practical pattern and clinical practice, provide evidences to the Medical Nutritional Treatment of GDM as a clinical route model.
Methods: A quasi-experiment study method was applied, using convenience sampling，historical control group and intervention group were set up. All objects followed regular prenatal examination, recorded in the files, diagnosed as GDM and labor in the certain hospital. 88 gravida were selected in historical control group, and 51 in intervention group. Control group adopted normal oral nutritional instruction from prenatal doctors , while Intervention group adopted one-day clinic intervention except conventional oral instruction . Data of gestational ending were analyzed using spss 16.0. In addition, interview were conducted, to get the acceptability and existing problems feedback, from intervention group gravida and doctors. Generic analysis including Induction and theme refining were used to analyze the data.
1. The incidence of Anemia during pregnancy in the intervention group was lower, than the historical control group(P＜0.05); There were no statistical significant differences between the two groups of the incidence of gestational proteinuria, premature rupture of membrane， ，oligohydramnios and P＞0.05interventionintervention
2. After the one-day Nutrition Clinic for GDdecreased; There were no statistical differences between the two groups of Neonate on the birth body length, body weight and neonatal Apgar score
3. There was no significant difference of gestational weight gain between the intervention group and the control group hen pre-pregnagestational weight gain of GDM gravida in the intervention group was higher than the control group.
4. Six themes were induced through depth interview by using categorization: The acceptance and satisfaction of the patients on the one-day Nutrition Clinic for GDwas high; Patients' cognition of GDM and diet, aherence to diet advice and the life-style were improved; The effect of participating of family membersn was approved; It is difficult to completely follow the dietary advice, and there were downward trends in adherence to diet advice close to full term; Integrating a variety of approaches to realize follow-up; The implementation of one-day Nutrition Clinic was conducive to the unified management of GDM patients, in addition, it reduced the GDM related admission.
Conclusion: The accept degree of one-day Nutrition Clinic practice mode was high, which could improve the nutritional therapy compliance of patients, and was conducive to the improvement of pregnancy outcomes .. In addition, it saved medical costs. But in the actual diet management, more concern should be paid on the individualized guidance and supervision of the patients eating out and together with families. The results and experience of the study was wanted to be used to improve clinical practical patter of Medical Nutritional Treatment of GDM.
|王巧红. 妊娠期糖尿病一日营养门诊实践效果分析[D]. 北京大学护理学院. 北京大学,2014.|