Abstract: Background　With the encouragement of the three-child policy in China, the change in dietary patterns, and the popularization of early screening for metabolic diseases in pregnancy, the incidence of hyperglycemia in pregnancy has been increasing year by year, bringing a heavy medical burden to pregnant women and their offspring, as well as to the family and society, and the effective management of patients with hyperglycemia in pregnancy is of great clinical significance. Objective　To construct the index system of grading management for patients with gestational hyperglycemia, improve the efficiency of clinical work, and provide theoretical basis for the management of patients with gestational hyperglycemia. Methods　Through literature search and group discussion, the index system of hierarchical management was initially formulated. 15 experts were interviewed twice by Delphi method, and the indexes were screened according to the indexes and the feedbacks of experts, determine the evaluation index system and use analytic hierarchy process to calculate the weight. Results　The recovery rates of the two rounds of expert inquiry were 100%, the authority coefficients were 0.772 and 0.850, and the Kendall coordination coefficients were 0.319 and 0.344, respectively(P<0.05). Hierarchical analysis yielded importance scores of 4.40 to 4.93 and 4.67 to 4.93 for primary and secondary indicators, respectively. Finally, the grading management index system of gestational hyperglycemia patients was determined, which included 3 first-level indexes, 10 second-level indexes and 28 third-level indexes. Conclusion　The index system for grading and managing patients with hyperglycemia in pregnancy in this study is scientific and reliable. It not only comprehensively assesses the health status of gestational diabetes mellitus patients, but also categorizes and assigns values to specific indexes, which helps clinicians to comprehensively and hierarchically manage their patients, and can provide references to the clinical work of healthcare professionals and improve work efficiency.

Key words: Gestational hyperglycemia, Triangle hierarchical management model, Analytic hierarchy process, Delphi method

摘要： 背景　随着我国全面三胎政策的鼓励实施、饮食结构模式的改变以及妊娠期相关代谢性疾病早筛的普及，妊娠期高血糖的发病率逐年升高，给个人、子代及家庭和社会带来沉重医疗负担，有效的管理对妊娠期高血糖患者具有重要的临床意义。目的　构建妊娠期高血糖患者分级管理指标体系，提高临床工作效率，为妊娠期高血糖患者的管理提供理论依据。方法　通过系统性文献检索与专家小组研讨，初步构建分级管理指标体系，邀请15名专家实施两轮德尔菲函询，依据指标筛选标准与专家反馈内容，最终确立分级管理指标体系框架并采用层次分析法测算各指标权重。结果　2轮专家函询问卷回收率均为100%，权威系数分别为0.772、0.850，2轮函询的肯德尔协调系数分别为0.319、0.344（P<0.05）。层次分析法得出一级指标的重要性评分为4.40~4.93分、二级指标的重要性评分4.67~4.93分。最终确定妊娠期高血糖患者分级管理指标体系包含3项一级指标、10项二级指标、28项三级指标。结论　本研究的妊娠期高血糖患者分级管理指标体系科学可靠。本指标体系兼具妊娠期糖尿病患者健康状态的全面评估功能与指标分类赋值优势，能够支撑临床的分层管理实践，为医护工作提供参考依据，进而提升工作效率。

关键词: 妊娠期高血糖, Triangle 分级管理模型, 层次分析法, 德尔菲法