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血糖管理中的手术前一天的质量差距:一项回顾性队列研究
Shannon M Ruzycki1,2, Tyrone G Harrison3,4, Kirstie C Lithgow3
1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Shannon.Ruzycki@ucalgary.ca.
Perioperative medicine (London, England)
|November 26, 2025
概括
术后高血糖是常见的,影响有或没有糖尿病的患者,导致更糟糕的结果,如更长的住院时间和增加的再入院. 在手术期间的葡萄糖监测和治疗中存在质量差距.
科学领域:
- 在外科手术期间的医学.
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 术后高血糖症与患者的不良结果有关,包括感染,再入院和死亡率.
- 在手术前一天的葡萄糖管理中发现质量差距对于提高患者安全至关重要.
研究的目的:
- 描述手术前一天的葡萄糖管理中的质量差距.
- 描述手术患者血糖控制的过程,结果和平衡措施.
- 探索高血糖和不良结果之间的关联.
主要方法:
- 使用行政和电子健康记录数据 (2019-2024) 的回顾性队列研究.
- 对加拿大阿尔伯塔省接受手术的成年患者的分析,按糖尿病状况分层.
- 检查了血糖测量,高血糖患病率,胰岛素使用,以及与停留时间,ICU入院和30天再入院的关联.
主要成果:
- 高血糖 (≥10.0 mmol/L) 在37.1%的糖尿病患者中被观察到,并且在10%以上的无糖尿病患者中也存在.
- 只有大约一半的患有高血糖症的糖尿病患者接受了胰岛素.
- 高血糖明显与更长的住院时间,更高的ICU入院率和增加的30天再入院率有关.
结论:
- 在糖尿病患者的血糖监测和高血糖治疗中发现了显著的质量差距.
- 在非糖尿病手术患者中,高血糖是普遍存在的,并且具有临床意义.
- 需要进一步的研究,以了解非糖尿病患者的高血糖症,并改善外科手术期间的葡萄糖管理.
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