护理专案在降低ICU静脉输注胰岛素患者低血糖发生率中的应用

Application of Nursing Project in Reducing the Incidence of Hypoglycemia in Patients with Intravenous Insulin Infusion in ICU

目的探究护理专案在降低ICU静脉输注胰岛素患者低血糖发生率中的作用。方法选取2020年7—12月该院ICU收治的55例接受静脉输注胰岛素治疗的危重患者为对照组,此阶段实施常规ICU专科护理;另选取2021年1—5月ICU收治的50例行静脉输注胰岛素治疗的危重症患者为观察组,此阶段开展预防低血糖的护理专案改善活动,比较两组患者每次静脉输注胰岛素后血糖达标平均时间、胰岛素累积量及胰岛素治疗期间血糖不稳定指数(GLI)及平均血糖波动幅度(MAGE),并记录低血糖发生情况。结果观察组每次静脉输注胰岛素的血糖达标平均时间、胰岛素累积量显著少于对照组,差异有统计学意义(P<0.05)。观察组患者治疗期间血糖不稳定指数、平均血糖波动幅度均显著低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组低血糖发生率及其低血糖持续时间明显少于对照组,差异有统计学意义(P<0.05)。观察组处置低血糖的护理工时、费用明显少于对照组,差异有统计学意义(P<0.05)。结论在ICU危重症患者静脉输注胰岛素治疗过程中开展护理专案活动能够有效缩短血糖达标时间,并减少血糖波动、低血糖发生,同时还可以提高ICU护士预防和快速处置低血糖事件。

Objective To explore the effect of nursing program in reducing the incidence of hypoglycemia in patients with intravenous insulin infusion in ICU.Methods 55 critically ill patients who were admitted to the ICU of the hospital from July to December 2020 and needed to receive intravenous insulin therapy were selected as the control group,and routine ICU specialist nursing was implemented at this stage.Another 50 critically ill patients admitted to the ICU from January to May 2021 who were treated with intravenous insulin infusion were selected as the observation group.At this stage,the nursing project improvement activities for the prevention of hypoglycemia were carried out,and the average time to reach the blood glucose target,the cumulative amount of insulin,the glycemic instability index(GLI)and the mean blood glucose fluctuation range(MAGE)during insulin treatment were compared between the two groups of patients after each intravenous infusion of insulin.and record the occurrence of hypoglycemia.Results The average time of blood glucose reaching the standard and the accumulated insulin volume of each intravenous infusion of insulin in the observation group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The blood glucose instability index and average blood glucose fluctuation range of the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.05).During the treatment period,the incidence of hypoglycemia and the duration of hypoglycemia in the observation group were significantly less than those in the control group,the difference was statistically significant(P<0.05).The nursing hours and cost of treating hypoglycemia in the observation group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Carrying out nursing project activities during the intravenous infusion of insulin therapy for critically ill patients in ICU can effectively shorten the time to reach the blood glucose standard,and reduce the occurrence of blood glucose fluctuations and hypoglycemia.At the same time,it can improve the prevention and rapid handling of hypoglycemic events by ICU nurses.