强化血糖监测在冠脉旁路移植术后患者血糖管理中的应用

目的探讨强化血糖监测护理方案对冠脉旁路移植术(CABG)术后转入普通病房的患者血糖变异性的影响。方法采用便利抽样法,选取北京安贞医院2018年6—12月入院行CABG于72 h内转出ICU的冠心病合并高血糖患者106例,按照随机数字表法分为对照组(54例)和研究组(52例)。对照组给予常规护理,研究组在对照组的基础上采用强化血糖监测在内的综合护理策略。比较两组CABG术后患者转至普通病房3 d内每日平均血糖水平(MGL)、血糖标准差(SD)、日内平均血糖波动幅度(MAGE)、血糖变异系数(CV)。结果患者从ICU转入普通病房后的MGL存在时间效应、组间效应以及时间和组间的交互效应;SD存在组间效应;MAGE存在时间和组间效应;CV存在组间效应以及时间和组间的交互效应。结论在患者转出ICU到普通病房术后1~3 d内,与常规护理组相比较,继续给予强化血糖监测与护理能够减少血糖变异程度。

Application of intensive blood glucose monitoring in blood glucose management of patients after coronary artery bypass grafting

Objective To investigate the effect of intensive blood glucose monitoring and nursing program on blood glucose variability of patients transferred to general wards after coronary artery bypass grafting(CABG).Methods A convenient sampling method was used to select 106 patients with coronary heart disease and hyperglycemia who were transferred from the ICU within 72 hours after CABG from Beijing Anzhen Hospital from June to December 2018.They were divided into control group(54 cases)and research group(52 cases)according to the random number table method.The control group was given routine nursing care,and the research group adopted a comprehensive nursing strategy including intensive blood glucose monitoring based on the control group.The average daily blood glucose level(MGL),standard blood glucose standard deviation(SD),daily average blood glucose fluctuation range(MAGE),and blood glucose variation coefficient(CV)of the two groups were compared within 3 days after CABG patients were transferred to the general ward.Results After the patients were transferred from the ICU to the general ward,there were time effects,inter-group effects,and time-group interaction effects in SD;inter-group effects in SD;time-and inter-group effects in MAGE;and inter-group effects and time and group in CV interaction effect.Conclusions Within 1 to 3 days after the patient is transferred from the ICU to the general ward,compared with the conventional nursing group,continued intensive blood glucose monitoring and nursing can reduce the degree of blood glucose variation.