临床药师参与骨科围术期2型糖尿病患者血糖管理的实践与效果分析

目的评价内分泌专业临床药师参与骨科糖尿病患者围术期血糖管理的效果,为进一步优化围术期血糖管理模式提供方案。方法以2018年10月至2019年7月在某院骨科住院的成人2型糖尿病患者208例为研究对象,随机分为对照组与干预组,对照组104例,接受传统的血糖管理,观察组104例,在对照组的基础上增加了内分泌专业临床药师的干预与管理,比较两组患者血糖达标率、低血糖发生率、平均住院日以及患者满意度,并对管理过程中药师提出的建议进行汇总。结果干预组患者血糖达标率明显高于对照组(70.04%±10.01%vs.51.76%±12.89%),低血糖的发生率明显低于对照组(0.79%±1.06%vs.2.52%±1.99%),平均住院天数有所改善(17.05±5.56)d vs.(14.16±4.66)d],此外,患者满意度提高。临床药师针对干预组药学监护提出的用药建议共272条,医生采纳了194条,采纳率为71.3%。结论临床药师的参与和管理可有效改善2型糖尿病患者围术期血糖情况,减少不良反应的发生。临床药师可作为多学科治疗团队中的一员,在围术期血糖管理中发挥重要作用。

Practice and effect analysis of clinical pharmacists participating in blood glucose management of perioperative patients with type 2 diabetes mellitus in orthopedics department

Objective To assess the effect of clinical pharmacists of endocrine disease intervention in blood glucose management of perioperative diabetic patients in orthopedics department,and to provide a reference method for perioperative blood glucose management.Methods Totally 208 adult patients with type 2 diabetes mellitus treated in our hospital from October 2018 to July 2019 were randomly assigned to intervention group(n=104)and control group(n=104).Patients received traditional blood glucose management in control group,while in intervention group,on the basis of treatment for control group,patients were given intervention and management by clinical pharmacists of endocrine diseases.The rate of blood glucose reaching target,incidence of hypoglycemic events,the average hospitalization days and patients′satisfaction were compared.The pharmacists′suggestions in the course of intervention were summarized.Results The rate of blood glucose reaching target in intervention group was significantly higher than that in control group(70.04%±10.01%vs.51.76%±12.89%),while the incidence of hypoglycemic events in intervention group was significantly lower than that in control group(0.79%±1.06%vs.2.52%±1.99%);the average hospitalization days were obviously decreased(17.05±5.56)d vs.(14.16±4.66)d].In addition,patients′satisfaction was improved significantly in intervention group.Clinical pharmacists provided 272 pieces of advice on medication in intervention group.Finally the doctors adopted 194 pieces,the adoption rate being 71.3%.Conclusion Intervention and management of clinical pharmacist can effectively improve the situation of hyperglycemia in patients with type 2 diabetes mellitus in perioperative period,and reduce adverse drug reaction.As a member of the multidisciplinary team of treatment,clinical pharmacists play an important role in blood glucose management in perioperative period.