医生对急诊血糖超过6.1mmol/L患者的诊治现状调查

目的调查急诊和病房医生对急诊随机毛细血管血糖或静脉血浆血糖大于或等于6.1mmol/L患者的检查、诊断和治疗情况。方法 2009年1月重庆市第四人民医院急诊科入院检查随机毛细血管血糖或静脉血浆血糖,血糖值大于或等于6.1mmol/L并住院的患者,查阅出院病历记录中是否复查血糖,以及诊断和治疗的情况。结果急诊血糖大于或等于6.1mmol/L且住院的患者共104例,11例在急诊室被诊断为糖尿病或高血糖;患者住院后复查血糖的69例,占所有患者的66.3%,做口服葡萄糖耐量试验(OGTT)的仅1例,占患者总数的0.98%,检查糖化血红蛋白(HbA1c)的15例,均值为7.86%;入院后被诊断为糖尿病的19例,诊断为葡萄糖耐量异常(IGT)的1例;24例使用胰岛素治疗,其中1例使用胰岛素加口服降糖药。结论急诊和病房医生可能低估了急诊血糖大于或等于6.1mmol/L人群的糖尿病流行情况。

Survey on current situation of diagnosis and treatment of patients with blood glucose over 6.1 mmol/L in emergency

Objective To investigate the detection,diagnosis and treatment of the patients with blood glucose over 6.1 mmol/L in emergency room and in wards.Methods The survey was conducted among the patients in one hospital in January/2009.The patients with capillary or plasma blood glucose ≥6.1 mmol/L were randomly screened in emergency room and then hospitalized.We recorded their clinical documents,including plasma blood glucose,diagnosis and treatment.Results 11 patients were diagnosed diabetes or hyperglycemia among 104 patients with blood glucose over 6.1 mmol/L in emergency department.Of the 104 patients,66.3% patients underwent plasma blood glucose detection and 0.9% oral glucose tolerance test （OGTT）,respectively.7.86% patients were performed HbA1c detection.18.26% and 0.9% patients were diagnosed as diabetes and impaired glucoses tolerance （IGT）,respectively.23.07% patients received insulin therapy,and 0.9% received insulin＋oral hypoglycemic agency （OHA）.Conclusion Doctors in wards and emergency department probably underestimate the prevalence of diabetes and impaired glucose regulation （IGR） in the population with blood glucose≥6.1 mmol/L in emergency.