终末期糖尿病肾病患者血液透析中血糖监测的研究

Study of Blood Glucose Monitoring in Different Parts of Diabetic Hemodialysis Patients

目的比较终末期糖尿病肾病患者血液透析中2个不同部位采血快速血糖值的差异,为制定血液透析过程中准确便捷的血糖监测方案提供依据。方法选取接受规律维持性透析治疗3个月以上且临床状况稳定的终末期糖尿病肾病患者61例,在患者血液透析治疗2 h后分别于体外循环输出端采样口和传统指端末梢2个部位采血,利用快速血糖仪监测血糖,比较2种不同部位采血所得血糖监测结果的差异性。结果61例终末期糖尿病肾病维持性血液透析患者用2种方法行血糖监测各220例次,体外循环输出端采样口采血所测得血糖值(8.679±3.395)mmol/L,指端末梢部位采血所测得血糖值(8.844±4.419)mmol/L,二者比较差异无统计学意义(P>0.05);Bland-Altman分析结果表明,2个部位采血监测血糖结果一致;2个部位采血监测低血糖的发生率比较差异无统计学意义(P>0.05)。结论终末期糖尿病肾病患者血液透析中血糖的监测,选择体外循环输出端采样口采血,此方法无创、无痛,能够提高患者血糖监测的依从性,可替代传统指端末梢采血。

Objective To compare the difference of fast blood glucose in 2 different parts of the extracorporeal circulation at the outlet of the cardiopulmonary bypass and the tip of the conventional tip in diabetic nephropathy maintenance hemodialysis patients,in order to provide some basis for making accurate and convenient blood glucose monitoring program during hemodialysis.Methods Self control study was used in this study.Included the regular dialysis for more than 3 months and stable clinical condition.After 2 hours of hemodialysis treatment,two trained nurses collected blood at the same time point from the sampling port at the output end of extracorporeal circulation and the traditional finger tip.The blood glucose level was detected by the rapid blood glucose meter,and the differences of blood glucose detection results between the two different parts were compared.Results A total of 61 diabetic nephropathy maintenance hemodialysis patients were enrolled in this study,including 32 males(52.46%),38~81 years old,and average age(61.00±11.90)years.The blood glucose measured at the outlet of CPB was(8.679±3.395)mmol/L,and the blood glucose measured at the finger tip was(8.844±4.419)mmol/L.the statistical results showed that there was no significant difference between the two groups(P>0.05).Bland Altman analysis showed that the consistency of the two methods was consistent.Conclusion For the blood glucose detection of patients with diabetic nephropathy maintenance hemodialysis,it is feasible to use online sampling at the outlet of the extracorporeal circulation.This method is noninvasive and painless.It can improve the compliance of blood glucose detection in patients with diabetic nephropathy maintenance hemodialysis,and the operation is quick,fast and effective.They can replace each other.