StatStrip血糖监测系统在心脏术后患者中的应用及评价

Evaluation of StatStrip glucose monitoring systems used on patients undergoing cardiac surgery

目的:评估StatStrip血糖监测系统在心脏术后血糖监控中的作用。方法:选择行体外循环心脏手术的患者160例,术后转入ICU时采集动脉血及指端血,分别用SureStep Flexx血糖仪和StatStrip血糖仪测定血糖值,同时将患者静脉血样送至中心实验室,测定红细胞比容(HCT)值及作为标准对照的血糖值,对两种血糖仪及两种血样测定血糖值的准确性进行评估,同时分析HCT对测定结果的影响。结果:无论是动脉血还是末梢血,StatStrip血糖仪的血糖测得值与标准血糖浓度之间均有良好的相关性(r=0.969 4,0.957 0),两者之间的差值不依赖于HCT而变化(r=-0.016 81,P=0.832 9),StatStrip的检测错误率与HCT的高低无明显联系。在HCT≤28%范围内,StatStrip检测的错误率显著低于SureStep Flexx(动脉血10.0%vs32.5%,末梢血12.5%vs 35.0%,P<0.05)。结论:对心脏术后患者采用StatStrip血糖监测系统测定动脉血糖为一种准确、无创的血糖监测手段,可使强化胰岛素治疗更加安全有效。

Objective： To assess the effect of StatStrip glucose monitoring system on the blood glucose monitoring and control in patients undergoing cardiac surgery. Methods： A total of 160 patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled. The blood samples from artery and capillary were collected when the patients were transferred to ICU after surgery,and blood glucose was measured on Sure Step Flexx and Stat Strip glucose monitors respectively. While the venous blood samples were sent to the central laboratory,HCT value was measured,as well as glucose concentration as standard comparison. The accuracy of the two kinds of glucose monitors and two kinds of the blood samples,and the impact on measurements of HCT were analyzed. Results：There was a good correlation in glucose concentration between the Stat Strip and the laboratory analyzer,both arterial blood and capillary blood（ r = 0. 969 4,0. 957 0）. The difference in glucose concentration between the Stat Strip and the laboratory analyzer was not dependent on HCT（ r =- 0. 016 81,P = 0. 832 9）. The inaccurate rate of Stat Strip had no apparent connection with HCT. In the range of HCT ≤28%,the inaccurate rate of Stat Strip was significantly lower than Sure Step Flexx（ arterial blood 10. 0% vs 32. 5%,capillary blood 12. 5% vs 35. 0%,P〈0. 05）. Conclusion： The measurement of arterial blood glucose with Stat Strip glucose monitoring system in patients undergoing cardiac surgery is an accurate,non- invasive blood glucose monitoring method,and it can make intensive insulin therapy more effective and safe.