Objective To observe effect by integrated management in improving high risk pregnancy outcome of gestational diabetes. Methods There were 130 high risk pregnant women with gestational diabetes in integrated management during January 2015~October 2016 as observation group and 140 high risk pregnant women with gestational diabetes and no integrated management during January 2013~December 2014 as control group. The control group received conventional pre-pregnancy examination of guidance, and the observation group received integrated management intervention, including management organization improvement, psychological support enhancement, diet health guidance, antenatal care guidance enhancement, exercise guidance, close monitoring, and telephone follow-up. Clinical effects in both groups were observed. Results Before intervention, there was no statistically significant difference of fasting blood glucose level between the two groups (P>0.05). Before delivery, the observation group had lower fasting blood glucose level as (5.88±0.48) mmol/L than (6.22±0.52) mmol/L in the control group (P<0.05). The observation group had higher compliance rate as 95.38%than 62.86% in the control group (P<0.05). The observation group had incidence of complication as 4.62%, incidence of adverse fetal outcome as 5.38% and incidence of progressed gestational diabetes as 3.08%, which were lower than 11.43%, 12.86% and 9.29% in the control group (P<0.05). Conclusion Implement of integrated management for high risk pregnant women with gestational diabetes can reduce blood glucose level, improve compliance and decrease complications, adverse fetal outcome and gestational diabetes.%目的：观察实施综合管理改善妊娠糖尿病高危孕妇妊娠结局的效果。方法2015年1月~2016年10月实施综合管理的妊娠糖尿病高危孕妇130例作为观察组,2013年1月~2014年12月未进行综合管理的140例妊娠糖尿病高危孕妇作为对照组,对照组进行常规孕前检查和指导,观察组实施综合管理干预,包括完善管理组织、加强心理支持、饮食保健指导、加强孕期保健指导、运动指导、密切监测、电话回访式。观察两组临床疗效。结果干预前,两组孕妇空腹血糖水平比较差异无统计学意义(P>0.05),分娩前,观察组空腹血糖水平为(5.88±0.48)mmol/L,低于对照组的(6.22±0.52)mmol/L (P<0.05)；观察组遵医行为好为95.38%,高于对照组的62.86%(P<0.05)；观察组孕妇并发症发生率为4.62%、胎儿不良结局发生率为5.38%、进展为妊娠糖尿病者为3.08%,低于对照组的11.43%、12.86%、9.29%(P<0.05)。结论对妊娠糖尿病高危因素孕妇实施综合管理的效果能够降低血糖水平,提高遵医行为,减少孕妇并发症及胎儿不良结局,减少妊娠糖尿病的发生。
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