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儿童胰岛自体移植胰腺切除术后的连续血糖监测

Continuous glucose monitoring following pancreatectomy with islet autotransplantation in children.

作者信息

Elder Deborah A, Jiminez-Vega Jose M, Hornung Lindsey N, Chima Ranjit S, Abu-El-Haija Maisam, Lin Tom K, Palermo Joseph J, Nathan Jaimie D

机构信息

Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

Pediatr Transplant. 2017 Nov;21(7). doi: 10.1111/petr.12998. Epub 2017 Jun 12.

Abstract

Aim was to determine whether CGM could accurately monitor blood glucose concentration in the immediate postoperative period following pancreatectomy with IAT in children. CGM was used in nine patients undergoing IAT at our institution between April 2015 and September 2016 (eight total pancreatectomy and one subtotal pancreatectomy). MAD and MARD of CGM values compared to time-matched serum blood glucose were calculated during the first 5 days of ICU admission. Goal range was defined as 70-140 mg/dL and out-of-range was >140 mg/dL or <70 mg/dL. Of 89 time-matched measures found, 75% of CGM values were within 15 mg/dL, and 51% were within 10 mg/dL, compared to serum glucose. MAD was 11.6 mg/dL, and MARD was 10.6%. CGM values did not differ from serum glucose (P=.74). By Clarke error grid analysis, 100% of paired values were in clinically acceptable zones. By surveillance error grid analysis, 96% of paired values were within clinically acceptable agreement. CGM is a reliable tool in monitoring glycemic control in the immediate postoperative period following pancreatectomy with IAT in children.

摘要

目的是确定动态血糖监测(CGM)能否准确监测儿童在胰十二指肠切除术(IAT)后即刻术后期间的血糖浓度。2015年4月至2016年9月期间,在我们机构对9例行IAT的患者使用了CGM(8例全胰切除术和1例次全胰切除术)。在入住重症监护病房(ICU)的前5天,计算CGM值与同期血清血糖相比的平均绝对差(MAD)和平均绝对相对差(MARD)。目标范围定义为70 - 140mg/dL,超出范围为>140mg/dL或<70mg/dL。在89次同期测量中,与血清葡萄糖相比,75%的CGM值在15mg/dL以内,51%在10mg/dL以内。MAD为11.6mg/dL,MARD为10.6%。CGM值与血清葡萄糖无差异(P = 0.74)。通过克拉克误差网格分析,100%的配对值处于临床可接受区域。通过监测误差网格分析,96%的配对值在临床可接受的一致性范围内。CGM是监测儿童IAT胰十二指肠切除术后即刻术后期间血糖控制的可靠工具。

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