Kambe Noriko, Kawahito Shinji, Mita Naoji, Takaishi Kazumi, Katayama Toshiko, Sakai Yoko, Soga Tomohiro, Kawano Hiroaki, Matsuhisa Munehide, Shimada Mitsuo, Kitagawa Tetsuya, Kitahata Hiroshi
Department of Anesthesiology, Tokushima University Hospital.
J Med Invest. 2015;62(1-2):41-4. doi: 10.2152/jmi.62.41.
Recent studies have shown that strict perioperative blood glucose management may reduce mortality and morbidity in critically ill adult patients. The purpose of this study was to assess the accuracy and efficacy of the intraoperative application of a newly developed, next-generation artificial endocrine pancreas (STG-55, Nikkiso Co., Ltd., Tokyo, Japan).
Twenty patients scheduled to undergo surgery were enrolled in this study. The STG-55 is designed to be more user-friendly than its conventional counterpart (STG-22) while maintaining the latter's fundamental functions, such as a closed-loop system using algorithms for insulin and glucose infusion. After anesthetic induction, a 20G intravenous catheter was inserted into a peripheral forearm vein and connected to a continuous blood glucose monitor. The resultant 105 scores for paired blood glucose values were compared by Bland-Altman analysis.
Stable blood glucose values were maintained automatically, and there were no complications related to use of the STG-55. A close correlation (r=0.96) was observed between continuous glucose measurements using the STG-55 and conventional intermittent glucose measurements. The difficulty of manipulation using this system was decreased by improved preparation procedures.
The glycemic control system using the STG-55 could provide an alternative way to achieve effective and safe perioperative glycemic control.
近期研究表明，严格的围手术期血糖管理可能降低危重症成年患者的死亡率和发病率。本研究的目的是评估新开发的下一代人工内分泌胰腺（STG - 55，日本东京日机装株式会社）在术中应用的准确性和有效性。
本研究纳入了20例计划接受手术的患者。STG - 55的设计比其传统型号（STG - 22）更便于使用，同时保留了后者的基本功能，如使用胰岛素和葡萄糖输注算法的闭环系统。麻醉诱导后，将一根20G静脉导管插入前臂外周静脉，并连接到连续血糖监测仪。通过Bland - Altman分析比较配对血糖值的105个得分。
血糖值自动维持稳定，且未出现与使用STG - 55相关的并发症。使用STG - 55进行的连续血糖测量与传统间歇性血糖测量之间观察到密切相关性（r = 0.96）。改进的准备程序降低了使用该系统的操作难度。
使用STG - 55的血糖控制系统可为实现有效且安全的围手术期血糖控制提供一种替代方法。
