Sheehy Ann M, Gabbay Robert A
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1261-9. doi: 10.1177/193229680900300605.
Perioperative hyperglycemia is a common phenomenon affecting patients both with and without a known prior history of diabetes. Despite an exponential rise in publications and studies of inpatient hyperglycemia over the last decade, many questions still exist as to what defines optimal care of these patients. Initial enthusiasm for tight glycemic control has waned as the unanticipated reality of hypoglycemia and mortality has been realized in some prospective studies. The recent dramatic modification of national practice guidelines to endorse more modest inpatient glycemic targets highlights the dynamic nature of current knowledge as the next decade approaches. This review discusses perioperative hyperglycemia and the categories of patients affected by it. It reviews current recommendations for ambulatory diabetes screening and its importance in preoperative patient care. Finally, it concludes with a review of current practice guidelines, as well as a discussion of future direction and goals for inpatient perioperative glycemic control.
围手术期高血糖是一种常见现象，影响着有或无已知糖尿病病史的患者。尽管在过去十年中，关于住院患者高血糖的出版物和研究呈指数级增长，但对于如何定义这些患者的最佳护理仍存在许多问题。随着一些前瞻性研究中低血糖和死亡率这一意外现实的出现，对严格血糖控制的最初热情已经消退。随着下一个十年的临近，最近国家实践指南的大幅修改以支持更适度的住院血糖目标，凸显了当前知识的动态性质。本综述讨论围手术期高血糖及其影响的患者类别。它回顾了当前关于门诊糖尿病筛查的建议及其在术前患者护理中的重要性。最后，它以对当前实践指南的回顾以及对住院围手术期血糖控制未来方向和目标的讨论作为总结。
