辽宁医学杂志

目的 探讨个体化医学营养治疗(MNT)联合胰岛素治疗妊娠期糖尿病(GDM)患者血糖控制、妊娠结局的影响。方法 选择2023年1月至2024年9月在我院门诊就诊的82例GDM患者，按随机对照原则分组。对照组(41例，实施胰岛素治疗),研究组(41例，实施MNT联合胰岛素治疗),均干预至分娩。对比两组血糖控制情况、生活质量水平、护理依从性、母婴不良妊娠结局。结果 研究组干预后糖化血红蛋白(HbA1c)、空腹血糖(FPG)以及餐后2 h血糖(2 hPG)水平均低于对照组(P<0.05);研究组干预后妊娠期糖尿病女性生活质量问卷-34(GDMQ-34)评分高于对照组(P<0.05);研究组护理依从性高于对照组更高(P<0.05);研究组母婴不良妊娠结局发生率低于对照组(P<0.05)。结论 联合方案(个体化医学营养治疗+胰岛素)用于GDM可有效提高患者对血糖的控制，有助于其护理依从性的提高，进而改善患者妊娠结局及生活质量。

Objective To explore the effect of individualized medical nutrition therapy(MNT) combined with insulin therapy on blood sugar control and pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods Eighty-two patients with GDM from January 2023 to September 2024 in our hospital were randomly divided into two groups.The control group(41 cases, treated with insulin) and the study group(41 cases, treated with MNT combined with insulin) all intervened until delivery.The blood sugar control, quality of life, nursing compliance and adverse pregnancy outcome of mother and baby were compared between the two groups.Results The study group had lower levels of fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),and 2 h postprandial blood glucose(2 hPG) than the control group after intervention(P<0.05).The score of GDMQ-34 in the study group was higher than that in the control group(P<0.05).The nursing compliance of the study group was higher than that of the control group(P<0.05).The incidence of adverse pregnancy outcomes in the study group was lower than that in the control group(P<0.05).Conclusion MNT can effectively improve the blood sugar level of GDM patients, improve their nursing compliance and quality of life, and reduce the occurrence of adverse pregnancy outcomes between mother and baby.