妊娠期糖尿病社区管理和妊娠结局分析.doc

妊娠期糖尿病社区管理和妊娠结局分析 　　[摘要] 目的 探讨如何建立妊娠期糖尿病的社区管理模式。 方法 进行前瞻性研究，在2011年9月～ 2012年9月到海珠区妇幼保健院和南方医科大学珠江医院产检的所有孕妇中抽取3000名20岁以上常住孕妇，筛查出糖尿病孕妇544 例。分成两组，观察组（300例）由医院和社区联合管理，对照组（244例）按照传统的医院产检方法管理。比较两组的妊娠结局。 结果 在妊娠合并症方面：观察组妊娠期高血压疾病、羊水过多、早产、产后出血的发生率均低于对照组（P0.05）；在围产儿预后方面：观察组巨大儿、低出生体重、新生儿低血糖发生率明显低于对照组（P0.05）。 结论 医院结合社区卫生服务中心联合管理妊娠期糖尿病孕妇，可进一步减少糖尿病孕妇及围生儿并发症。 　　[关键词] 妊娠糖尿病；社区管理；妊娠结局 　　[中图分类号] R714.25 [文献标识码] B [文章编号] 2095-0616（2013）14-148-03 　　Analysis on community management of gestational diabetes mellitus and pregnancy outcome 　　PAN Dongna DU Dan LIU Chuanyong 　　Maternal and Child Care Service Centre of Haizhu Distric in Guangzhou City，Guangzhou 510000，China 　　[Abstract] Objective To explore how to establish community management model of gestational diabetes mellitus. Methods A prospective study was performed in 544 pregnant women with diabetes who come from HaiZhu Women and Children hospital and ZhuJiang Hospital of Southern Medical University from September 2011 to September 2012.All pregnant women with diabetes were divided into observation group （n=300） and control groups（n=244）randomly.The patients in observation group received hospitals and community joint management and those in control group received traditional methods. The pregnancy outcome of two groups was compared. Results In the pregnancy complications，the incidence rate of gestational hypertension， polyhydramnios，premature delivery and postpartum hemorrhage in observation group were lower than the control group（P0.05）.In the perinatal prognosis，the incidence rate of fetal macrosomia， low birth weight and neonatal hypoglycemia in observation group were significantly reduced compared with control group （P0.05）. Conclusion The management of gestational diabetes combined with hospital and community health service center can reduce the complications of diabetic pregnant women and perinatal infant. 　　[Key words] Gestational diabetes mellitus；Community management；Pregnancy outcome 　　妊娠期糖尿病（gestational diabetes me