住院糖尿病患者快速血糖监测管理及分析

Management and analysis of fast blood glucose in hospitalized patients with diabetes mellitus

目的：调查综合医院各科室住院糖尿病患者快速血糖监测及管理情况,并对结果进行分析。方法以某三级甲等综合医院14个科室收治的糖尿病住院患者为研究对象,收集和分析2013年1—12月住院期间的快速指血血糖监测数据。结果共收集快速血糖监测数据116618个,整体血糖达标61136个（达标率为52.4%）。全天各监测时间段中,晚餐前和睡前的血糖达标情况好于其他时间段,达标率分别为59.3%和59.4%,空腹和晚餐后血糖达标率最低,为41.8%和48.5%。全天24 h中,发生低血糖较多的是夜间时段,尤其是凌晨1：00—4：00,其次是睡前22：00—23：00。14个科室中,CCU、普外二病区、ICU高血糖发生率较高,分别高达55.2%,50.0%,47.7%；ICU、心内科、CCU低血糖发生率较低。结论非糖尿病专科高、低血糖的监测及处理流程待完善,需进一步加强院内多学科联合护理。

Objective To investigate and analyze observation and management of fast blood glucose in hospitalized patients with diabetes mellitus in some departments of general hospitals. Methods Study subjects, hospitalized patients with diabetes mellitus, were recruited from 14 departments of a third grade class A general hospital. Their monitoring data of fast finger blood glucose from January 2013 to December 2013 was collected and analyzed. Results Total blood glucose monitoring data was collected 116 618 with 61 136 （ 52. 4%）＆amp;nbsp;attaining a designated standard. Blood glucose, which was at target levels before dinner and bedtime, was better than other time periods among monitoring periods in a day with passing rate of 59. 3% and 59. 4%. Passing rate of fasting plasma glucose and plasma glucose of after supper were the lowest, 41. 8% and 48. 5%. The incidence of hypoglycemia was more at night time, especially in the early hours of 4：00-1：00, followed by bedtime of 22：00-23：00 throughout the 24-hour. Prevalence of hyperglycemia in CCU, second wards of General Surgery, ICU were 55. 2%, 50. 0%, 47. 7%. However, Prevalence of hypoglycemia in ICU, Cardiovascular Department, CCU was lower. Conclusions Monitoring and treatment process of hyperglycemia and hypoglycemia in non diabetic specialist should be improved. The role of multidisciplinary care in hospital should be further strengthened.