肝移植术后24h血糖监测分析及护理对策研究

Research on postoperative 24 hours blood sugar monitoring analysis and nursing policy for patients with liver-transplanted

目的了解肝移植患者术后24 h内血糖的变化规律,总结肝移植术后有效血糖监测及护理措施,为规范肝移植术后护理程序提供依据。方法采用罗氏血糖仪测量并记录147例肝移植术后转入ICU的患者术前、术后、返ICU后即刻,以及术后2 h4、h8、h、12 h、24 h等时间点的血糖及胰岛素用量,并进行统计分析。结果肝移植患者术后24 h内的血糖较术前明显升高(P=0.000)。其中以术后即刻、术后2 h、4 h的血糖值升高最为明显,且术后4 h胰岛素用量最大。结论肝移植患者术后24 h内血糖波动大,控制困难,应采用连续血糖监测的方法,尽快掌握血糖的变化规律,通过对胰岛素泵速的合理调整,达到平稳降糖的目的。

Objective To learn and analyze the patients＇ blood sugar fluctuating rules in 24 hours after receiving the liver transplantation, conclude the policies of blood sugar monitor and nursing, and offer the basement for the clinical nursing program of liver transplanting. Method Using the ACCU-CHEK blood glucose meters to observe the liver-transplanted ICU patients＇blood sugar and the dosage of insulin in the time points bellows; before operation, turning to ICU immediately and 2.4.8.12 and 24 hours, and make the statistical analysis. Result The patients＇blood sugar ascend greatly after entering ICU for 24 hours（P= 0. 000）, especially in turning to ICU immediately and 2 hours.4 hours after operation. And the dosage of insulin is biggest at postoperative 4 hours. Conclusion The liver- transplanted patients＇blood sugar changes greatly in the 24 hours after operation and are hard to control. We should take the blood sugar monitor measures continuously, and control it steadily.