严重腹腔感染病人营养支持治疗血糖调控的应用效果

The effect of glycemic control on severe intra-abdominal infection patients underwent nutrition

目的:通过便于护理人员掌握的血糖调控方案,确立血糖控制目标值,观察不同血糖水平对病人预后的影响。方法:采用我科自行设计的血糖调控操作方案,对92例严重腹腔感染并行营养治疗的病人进行血糖调控。血糖目标值为4.4～8.33 mmol/L,连续监测72 h。根据病人平均血糖值分为A组(血糖4.4～8.33 mmol/L)、B组(血糖8.34～10.0 mmol/L)和C组(血糖>10.0 mmol/L);再根据病人血糖与标准差值分为①组(血糖差值≤1.50 mmol/L)、②组(血糖差值1.51～2.50 mmol/L)和③组(血糖差值>2.50 mmol/L)。分别比较三组间低血糖的发生率和病死率等。结果:根据血糖均值比较:A组病人与B组和C组比,低血糖的发生率和病死率均有统计学意义;根据血糖标准差值比较,差值越大低血糖的发生概率越高,病死率亦增加。结论:严重腹腔感染行营养治疗的病人,将血糖控制在4.4～8.33 mmol/L,动态调控血糖,并减少血糖波动,可改善病人的预后。

Objective： To investigate the target value of glycemic control through the proposal handled by nurses and observe the clinical efficiency of different levels of blood glucose.Methods： 92 severe intra-abdominal infection patients underwent nutrition in our ward from Jan.2010 to Jun.2011 were treated with our proposal of glycemic control.The target value was 4.4~8.33 mmol/L.Blood glucoses were monitored within 72 h and the average value and standard deviation were calculated.We designed three groups by average value,group A of 4.4~8.33 mmol/L,group B of 8.34~10.0 mmol/L,and group C 10.0 mmol/L.There were three groups by standard deviation,group①≤1.50 mmol/L,group ② between 1.51~2.50 mmol/L and group③2.50 mmol/L.Mobidity of hypoglycemia and mortality were compaired.Results： By the comparison of average values,group A had statistically significant difference with group B and group C respectively.By the comparison of standard deviations,mobidity of hypoglycemia and mortality were increased with higher deviations.Conclusion： To control the blood glucose within 4.4~8.33 mmol/L through the proposal handled by nurses on severe intra-abdominal infection patients underwent nutrition can improve clinical efficiency.It is important to control blood glucose beside bed to reduce its fluctuation.