瞬感扫描式葡萄糖监测在Ⅱ型糖尿病病人胃肠癌围手术期的应用研究

Applied research on flash glucose monitoring in type 2 diabetes mellitus patients with gastrointestinal cancer during perioperative period

目的:研究瞬感扫描式葡萄糖监测在Ⅱ型糖尿病病人胃肠癌围手术期治疗中的临床应用价值。方法:选取2018年9月至2021年2月间就诊于解放军联勤保障部队第九〇〇医院普通外科接受胃肠癌手术并符合纳入标准的98例Ⅱ型糖尿病病人,按照随机数字表法分为观察组(n=48)和对照组(n=50),观察组采用瞬感扫描式葡萄糖监测,对照组采用毛细血管血糖监测,围手术期均严格执行血糖监测管理,其余治疗一致。比较分析两组治疗前后平均空腹血糖(FPG)、平均餐后2 h血糖(2h PG)、高或低血糖发生次数、胰岛素用量、并发症发生率、住院时间、术前血糖达标时间、治疗费用及治疗满意度。结果:治疗前两组病人的基线资料比较差异无统计学意义(P>0.05);观察组和对照组测血糖的准确性与静脉生化葡萄糖无明显差异(P均>0.05),准确性均良好;观察组术前平均FPG、术前平均2 h PG、术后平均FPG、术后平均2 h PG均优于对照组(P<0.05);观察组发生高、低高血糖次数、术前血糖达标时间均优于对照组(P<0.05);两组并发症发生率无明显统计学差异(P>0.05);观察组胰岛素用量及住院时间较对照组均减少(P<0.05),两组治疗总费用无差异(P>0.05);观察组治疗满意度明显高于对照组(P<0.05)。结论:扫描式葡萄糖监测应用于Ⅱ型糖尿病病人胃肠癌围手术期的血糖监测及降糖治疗,准确性良好,提高了围手术期的血糖达标率,具有很高的临床应用价值。

Objective:To study the clinical application value of flash glucose monitoring(FGM)in the perioperative treatment of gastrointestinal cancer in type 2 diabetic patients.Methods:A total of 98 patients with type 2diabetes who underwent gastrointestinal cancer surgery in our hospital between September 2018 and February 2021 were selected and divided into observation group(n=48)and control group(n=50)according to the random number table method.The observation group used FGM,and the control group used capillary blood glucose monitoring.The blood glucose monitoring and management were strictly implemented during the perioperative period,and the rest of the treatment was the same.The two groups were compared and analyzed the average fasting blood glucose(FPG)before and after treatment,the average 2 hours postprandial blood glucose(2h PG),the number of high or low blood glucose,insulin dosage,complication rate,hospital stay,preoperative blood glucose standard time,treatment cost and treatment satisfaction.Results:The baseline data of the two groups of the patients before treatment were not statistically significant(P>0.05).There were no significant difference in the accuracy of blood glucose measurement and the venous biochemical glucose between the two groups(P>0.05),and the accuracy of blood glucose measurement was good.The average preoperative FPG,preoperative average 2h PG,postoperative average FPG,and postoperative average 2h PG of observation group were significantly better than the control group(P<0.05).The occurrence of hypoglycemia,the number of hyperglycemia,and the preoperative blood glucose standard time of observation group were significantly better than the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The insulin dosage and hospital stay in the observation group were both lower than those in the control group(P<0.05).There was no difference in the total cost of treatment between the two groups(P>0.05).The treatment satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The accuracy of FGM is good to the gastrointestinal cancer patients with type 2 diabetes for the perioperative blood glucose monitoring and hypoglycemic treatment,which is helpful to improve the perioperative blood glucose compliance rate.It has high clinical application value.