围手术期住院患者的血糖管理现状及预后的影响

The status quo and prognosis of perioperative inpatients with blood glucose management

目的:分析其围手术期血糖管理情况,了解其中存在的不足之处,并提出改进建议。方法:选取骨一区、骨二区、手足外科及眼科住院患者753人,调查患者中糖尿病及高血糖的患病率、血糖管理现状、术后并发症、住院日及住院费用、出院医嘱血糖治疗有关管理。结果:753例患者中,明确诊断为糖尿病(diabetes mellitus,DM)的患者195例,占 25.90 %;诊断DM前期患者219例,占比29.08 %。328例手术患者中,不同血糖控制水平术后并发症各组间比较差异无统计学意义( P >0.05)。753例患者中,高血糖患者414例,正常血糖患者339例,两组患者住院费用、住院时间比较差异具有统计学意义( P <0.05)。结论:目前围手术期住院患者的血糖管理还存在许多不足,重视对围手术期住院高血糖患者的宣教、血糖监测及管理和出院医嘱,有助于改善患者预后,缩短平均住院日,提高患者的满意度,具有经济学效益。

Objective:To investigate and analyze the prevalence of hyperglycemia in patients admitted to the department of orthopedics, the department of orthopedics, the department of orthopedics, the department of orthopedics and the department of ophthalmology in our hospital, analyze the perioperative blood glucose management, understand the deficiencies and put forward suggestions for improvement.Methods:To investigate the prevalence of diabetes and hyperglycemia, the status quo of blood glucose management, postoperative complications, hospitalization days and hospitalization expenses, and the management of blood glucose treatment ordered by doctors after discharge in patients admitted to orthopaedic surgery and ophthalmology in the first and second bone regions.Results:753 patients in the first and second bone districts, hand and foot surgery and ophthalmology departments of our hospital were investigated. Among the 753 patients, 195 patients were definitely diagnosed with DM in hospital, accounting for 25.90 %, and 31 patients were definitely diagnosed with DM in hospital, accounting for 4.12 %. 219 patients with pre-dm were diagnosed, accounting for 29.08 %. Among 328 patients undergoing surgery, there was no significant difference in postoperative complications between the groups with different glucose control levels, P >0.05. Among the 753 patients, there were 414 patients with hyperglycemia and 339 patients with normal glycemia. There were statistically significant differences in hospitalization costs and length of stay between the two groups ( P <0.05).Conclusion:At present, there are still many deficiencies in perioperative inpatients' blood glucose management. Paying attention to the publicity and education, blood glucose monitoring and management, and discharge orders for perioperative inpatients with hyperglycemia can help improve the prognosis of patients, shorten the average hospitalization day, and improve the satisfaction of patients, which has economic benefits.