多学科合作结合一体化系统管理模式在围手术期住院患者血糖管理中的应用

Effect of Multidisciplinary Cooperation and Integrated System Management Model in Perioperative Blood Glucose Management of Inpatients

目的 分析多学科合作结合一体化系统管理模式在围手术期住院患者血糖管理方面的效果。方法 选取2018年1月~2020年12月惠州市中心人民医院收入的围术期高血糖患者180例。以随机数字表法分成研究组60例、对照组120例。对比2组有效性指标(FBG、2hPBG、HbA1c、血糖达标时间和达标率、胰岛素用量、伤口愈合等级及天数、平均住院时长)、安全性指标(血糖波动、低血糖及并发症发生率)、卫生经济效应(患者满意度、平均血糖控制及住院费用)。结果 与对照组进行对比,研究组FBG、2hPBG、HbA1c控制在更低水平,血糖达标用时更少,但达标率更高,胰岛素总用量和日均剂量均更低,患者伤口愈合时间和平均住院天数均更短,而手术切口愈合情况明显更优,差异有统计学意义(P<0.05)。2组患者低血糖概率对比无明显差异(P>0.05),研究组的日间、日内血糖波动以及术后并发症发生率均比对照组更小(P<0.05)。于对照组而言,研究组在医护满意度方面的评分更高,虽然平均血糖管理费更多,但其住院费明显更低,差异有统计学意义(P<0.05)。结论 多学科结合一体化系统管理模式对围术期住院患者血糖管理有较好的效果,值得临床推广。

Objective To analyze the effect of multidisciplinary cooperation combined with integrated system management model on blood glucose management of inpatients during perioperative period.Methods 180 perioperative hyperglycemia patients were selected from the income of Huizhou Central People’s Hospital from January 2017 to June 2020.The random number table method was divided into 60 cases in the study group and 120 cases in the control group.efficacy indicators (FBG,2hPBG,HbA1c,blood glucose up-to-date and up-to-date,insulin dosage,wound healing grade and days,average length of hospitalization),safety indicators (blood glucose fluctuations,hypoglycemia and incidence of complications),and health economic effects (patient satisfaction,average blood glucose control,and hospitalization costs) were compared between the two groups.Results Compared with the control group,the FBG,2hPBG,HbA1c of the study group was lower,the blood glucose was lower,but the rate of blood glucose reached the standard was higher,the total insulin dosage and daily average dose were lower,the wound healing time and average hospitalization days were shorter,and the surgical incision healing was significantly better(P<0.05).Although there was no significant difference in the incidence of hypoglycemia between the two groups (P>0.05),the fluctuation of daytime and intraday blood glucose fluctuation and postoperative complications in the study group was smaller than that in the control group(P<0.05).In the control group,the study group scored higher in terms of medical satisfaction.Although the average blood sugar management fee was significantly higher,the hospitalization fee was significantly lower,and the difference was statistically significant (P<0.05).Conclusion The multidisciplinary and integrated system management model has good effect on the blood glucose management of perioperative inpatients,which is worthy of clinical application.