【摘要】 目的调查孕妇的孕期知识、态度和行为情况,探讨个体化干预在孕妇体重和血糖管理中的作用。方法采用自制知信行问卷(Knowledge-Attitude-Practice,KAP)对177名孕13周的孕妇进行问卷调查,将调查对象随机分观察组90例和对照组87例。观察组采用"个体化干预",对照组采用常规健康教育,观察2组孕妇的体重情况、OGTT结果、分娩方式及巨大儿发生情况。结果 177名孕妇KAP问卷各维度得分情况:知识(5.0±1.6)分,态度(6.2±1.0)分,行为(14.1±2.5)分,KAP平均得分(25.3±3.5)分,观察组和对照组在孕13周的得分情况未见统计学差异。干预后,观察组孕期总增重为(13.2±2.4)g;对照组孕期总增重为(17.3±2.9)kg,两组比较差异有统计学意义(P<0.001)。观察组OGTT的空腹血糖(4.45±0.51)mmol/L和餐后2h血糖(5.28±0.36)mmol/L结果均低于对照组(4.90±0.95)mmol/L、(7.21±1.09)mmol/L(P<0.001)。观察组剖宫产率(8.9%)、巨大儿率(5.6%)低于对照组的21.8%和14.9%(P<0.05)。结论个体化干预可有效控制孕期体重增长,降低剖宫产率和巨大儿发生率,在今后产科的健康管理中应重视个体化干预。更多还原

【Abstract】 Objective To investigate the knowledge,attitude and practice(KAP)of pregnant women during pregnancy,and to study the effect of individual intervention on the body weight and blood glucose management.Methods 177 pregnant women were investigated by self-designed KAP questionnaire.The subjects were randomly divided into test group(n=90)and control group(n=87).The patients in test group received the "individual intervention" and patients in control group received the conditional health education.The weight,OGTT results,production mode and the occurrence of giant baby were compared in 2groups of pregnant women.Results The score of177 pregnant women was knowledge(5.0±1.6),attitude(6.2±1.0),behavior(14.1±2.5),KAP average score was 25.3±3.5,and there was no statistical difference in test group and control group at 13 weeks of pregnancy.The total weight gain of the test group was(13.2±2.4)kg,and(17.3±2.9)kg in the control group,and there was significant difference(t=10.36,P<0.001).The fasting blood glucose(4.45±0.51)mmol/L 2hour blood glucose(5.28±0.362)mmol/L in the test group were much lower than that of the control group(4.90±0.95,7.21±1.09)mmol/L,and there was significant differences(t=3.94,15.85,P<0.001).The cesarean section rate(8.9%)and macrosomia rate(5.6%)in the test group were much lower than that of the control group(21.8%,14.9%),There was significant difference(t=5.74 and 4.27,P=0.02 and 0.04).ConclusionIndividual intervention can effectively control the weight gain during pregnancy,reduce the rate of cesarean section and the incidence of giant baby.The individual intervention should be paid more attention in the health management for pregnancy women in the future.更多还原