瞬感血糖监测系统在髋部骨折合并糖尿病患者围手术期应用的效果评价

Evaluation of the effect of instant blood glucose monitoring system in perioperative blood glucose management in patients with hip fracture complicated with diabetes mellitus

目的探讨瞬感血糖监测系统(FGM)在髋部骨折合并糖尿病患者围手术期血糖管理中的应用效果,为围手术期血糖管理提供指导。方法选取2018年7月至2020年7月于上海市浦东新区公利医院骨科就诊的100例髋部骨折合并糖尿病患者为研究对象,采用随机数字法分为试验组和对照组,每组50例,2组患者均采用多学科协作模式,试验组采用基于FGM监测血糖,对照组采用传统血糖监测,比较2组患者术前等待时间、患者监测血糖针刺带来的疼痛感、患者及医护人员满意度、不同时间点的血糖水平及不良反应发生率。结果试验组患者术前等待时间、针刺中重度疼痛患者比例及高血糖发生率分别为(2.58±1.30)d、2%(1/50)、30%(15/50),低于对照组的(3.67±1.59)d、22%(11/50)、50%(25/50),差异有统计学意义(t值为-2.087,χ2值为9.470、4.170,均P<0.05)。试验组患者满意度及医护人员满意度分别为(46.43±1.87)、(46.58±2.10)分,高于对照组的(40.67±3.24)、(43.84±2.92)分,差异有统计学意义(t值为8.441、8.087,均P<0.05)。2组患者空腹血糖、餐后2 h血糖及睡前血糖比较差异无统计学意义(P>0.05)。结论应用FGM能够实现对髋部骨折合并糖尿病患者持续进行血糖监测及管理,使血糖达标更迅速和平稳,有效缩短术前等待时间,减轻监测血糖的针刺疼痛感,有效发现患者隐匿的血糖异常,提高患者及医护人员满意度,促进患者快速康复。

Objective To explore the effect of instant blood glucose monitoring system(FGM)in perioperative blood glucose management in patients with hip fracture complicated with diabetes mellitus,and to provide guidance for perioperative blood glucose management.Methods A total of 100 patients with hip fracture complicated with diabetes mellitus treated in the Department of Orthopaedics,Gongli Hospital,Pudong New Area,Shanghai from July 2018 to July 2020 were selected as subjects.The patients were divided into experimental group and control group by random digits table method with 50 cases in each group.The patients in both groups adopted the mode of multidisciplinary cooperation.The experimental group was used to monitor blood glucose based on FGM,and traditional blood glucose monitoring was used in the control group.The waiting time before operation,the pain caused by blood glucose acupuncture,the satisfaction of patients and medical staff,the blood glucose level at different time points and the incidence of adverse reactions were compared between the two groups.Results The waiting time before operation,the proportion of patients with moderate and severe pain after acupuncture and the incidence of hyperglycemia in the experimental group were(2.58±1.30)d,2%(1/50)and 30%(15/50),respectively,the control group were(3.67±1.59)d,22%(11/50)and 50%(25/50),respectively.The differences were statistically significant(t value was-2.087,χ2 values were 9.470,4.170,P<0.05).The satisfaction of patients and medical staff in the experimental group were(46.43±1.87),(46.58±2.10)points,respectively,the control group were(40.67±3.24),(43.84±2.92)points,respectively.The differences were statistically significant(t values were 8.441,8.087,P<0.05).There was no significant difference in fasting blood glucose,2-hour postprandial blood glucose and pre-bedtime blood glucose between the two groups(P>0.05).Conclusions The application of FGM can realize the continuous blood glucose monitoring and management of patients,making the blood glucose reach the standard more quickly and smoothly,meanwhile it may effectively shorten the waiting time before operation and reduce the acupuncture pain of blood glucose monitoring and recognize patients with concealed abnormal blood glucose.The application can improve the satisfaction of patients and medical staff,and promote the rapid recovery of patients as well.