Abstract: Background　The incidence of gestational diabetes mellitus（GDM） has been increasing gradually in recent years，which seriously affects the outcome of pregnancy and increases the risk of type 2 diabetes，metabolic syndrome and obesity among mothers and their offspring.Objective　To study the effects of contractual management on benefit finding in patients with GDM.Methods　Using convenient sampling，from Obstetrics Outpatient Clinic，the Third Affiliated Hospital of Zhengzhou University during February to November 2017，we selected 82 cases of GDM who received the services of personal medical card establishment during pregnancy and regular antenatal care，and underwent delivery in this hospital.By use of the random number table，we stratified them into the control group（41 cases） and the intervention group（41 cases），receiving regular antenatal care and health education，regular antenatal care and health education and contractual management，respectively.The scores of the Chinese version of Benefit Finding Scale （BFS-RC） and its domains in both stoups were assessed and compared at baseline and 24 hours after the delivery，respectively.The mode of delivery，gestational weight gain，body weight at delivery，fasting plasma glucose（FPG） and 2-hour postprandial glucose（2 h PG） after delivery were also compared between the two groups.Results　Before intervention，the scores of the Chinese version of BFS-RC and its 6 domains（acceptance，family relationship，worldview，personal growth，social relations，and health behaviors） between the two groups were not different significantly（P>0.05）．After the intervention，they increased significantly in the intervention group rather than the control group with obvious differences （P<0.05）．The rate of cesarean section，gestational weight gain，body weight at delivery，FPG and 2 hPG after delivery were all much lower than those of the control group （P<0.05）．Conclusion　Contractual management can increase the benefit finding in patients with GDM，and helps to control body weight and blood sugar level during pregnancy，and improve the outcome of childbirth.

Key words: Diabetes, gestational；Contract management；Benefit finding

摘要： 背景　妊娠期糖尿病（GDM）近年来发病率逐渐升高，严重影响妊娠结局，增加母亲及子代发生2型糖尿病、代谢综合征及肥胖等相关疾病的风险。目的　探讨契约式管理对GDM患者疾病获益感的影响。方法　采用便利抽样法，选取2017年2月—11月在郑州大学第三附属医院产科门诊建卡、定期产检并计划在本院分娩的82例GDM患者。采用随机数字表法将患者分为对照组和干预组，各41例。对照组实施常规妊娠期保健及健康教育。干预组在对照组基础上实施契约式管理。分娩后24 h，比较两组患者干预前后中文版疾病获益感量表各维度得分及其总得分；比较两组患者分娩方式、妊娠期体质量增长值、分娩时体质量、分娩后空腹血糖、分娩后餐后2 h血糖。结果　两组患者干预前接受、家庭关系、世界观、个人成长、社会关系、健康行为维度得分及中文版疾病获益感量表总得分比较，差异无统计学意义（P>0.05）；干预组患者干预后接受、家庭关系、世界观、个人成长、社会关系、健康行为维度得分及中文版疾病获益感量表总得分高于对照组（P<0.05）。干预组患者剖宫产率、妊娠期体质量增长值、分娩时体质量、分娩后空腹血糖、分娩后餐后2 h血糖均低于对照组（P<0.05）。结论　契约式管理有助于提高GDM患者的疾病获益感，控制妊娠期体质量和血糖，改善分娩结局。

关键词: 糖尿病, 妊娠；契约式管理；疾病获益感