基于胰岛素泵治疗的院内血糖管理现状调查分析

目的 调查广州市某三级甲等综合医院基于胰岛素泵治疗的院内血糖管理现状。方法 分析286例实施胰岛素泵治疗患者餐前、餐后2 h血糖(2 hour postprandial blood glucose,2h PBG)检测率,高血糖、低血糖及严重低血糖发生情况,对比非内分泌科与内分泌科的差异。 结果 非内分泌科胰岛素泵治疗的患者餐后2 h血糖检测率为33.12%,糖基化血红蛋白检测率为75.16%,均明显低于内分泌科患者(χ²=94.272,P<0.001; χ²=37.104,P<0.001)。非内分泌科低血糖与严重低血糖密度明显高于内分泌科,其中外科低血糖密度最高。非内分泌科与内分泌科使用胰岛素泵患者血糖总达标率比较,差异无统计学意义(χ²=2.697,P=0.101),非内分泌科不同科室患者血糖总达标率比较,差异有统计学意义(χ²=18.900,P=0.002)。结论 非内分泌科应加强对胰岛素泵治疗患者的血糖监测,结合科室特点积极预防低血糖的发生,降低院内血糖管理风险,提升血糖达标率。

In-hospital blood glucose management based on insulin pump treatment

Objective To investigate the present situation of in-hospital blood glucose management based on insulin pump treatment in a class 3 grade A hospital in Guangzhou. Methods The normal rate of preprandial and postprandial, as well as the incidence of hyperglycemia, hypoglycemia and severe hypoglycemia was measured for 286 patients, and compared between the patients from the endocrinology department and those from other departments. Results The detection rates of postprandial blood glucose and glycosylated hemoglobin were 32.94% and 75.16% for patients not from the endocrinology department, which were significantly lower than those of patients of endocrinology department(χ²=94.272,P<0.001; χ²=37.104,P<0.001). The incidence of hypoglycemia and severe hypoglycemia of non-endocrinology patients was significantly higher than that of endocrinology patients, with the highest among patients from the surgery department. There was no difference in the normal blood glucose rate between endocrinology and non-endocrinology patients(χ²=2.697, P=0.101). However, significant differences were found in the normal rate of blood glucose among patients from other departments except endocrinology department (χ²=18.900, P=0.002). Conclusion Departments other than the endocrinology department should strengthen the monitoring of blood glucose of patients with insulin pump, so as to prevent the occurrence of hypoglycemia and reduce the risk of in-hospital abnormal blood glucose and realize the normalization of the blood glucose.