基于信息化的血糖团队管理对非重症监护单元高血糖控制的影响。
Effect of informatization-based blood glucose team management on the control of hyperglycaemia in noncritical care units.
机构信息
Department of Endocrinology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
出版信息
PLoS One. 2020 Mar 11;15(3):e0230115. doi: 10.1371/journal.pone.0230115. eCollection 2020.
PURPOSE
To provide a new system of in-hospital blood glucose team management combined with a network blood glucose monitoring system and analyse the effect on hyperglycaemic participants' blood glucose control in noncritical care units.
METHODS
Hyperglycaemic participants in noncritical care units were divided into two groups. They underwent active intervention by the hospital's blood glucose management team or the routine consultation group. The better method, based on a shorter length of stay (LOS) and lower hospital cost, could be selected by comparing the two blood glucose management strategies.
RESULTS
Compared with the routine consultation group, the team management group had a higher detection rate of hyperglycaemia (18.49% vs 16.17%, P<0.01) and glycosylated haemoglobin (51.53% vs 30.97%, P<0.01) and a lower incidence rate of hyperglycaemia (59.24% vs 61.59%, P<0.01), severe hyperglycaemia (3.56% vs 5.19%, P<0.01) and clinically significant hypoglycaemia (0.26% vs 0.35%, P<0.05). Simultaneously, blood glucose drift (mmol/L) (2.50 (1.83, 3.25) vs 2.76 (2.01, 3.57), P<0.01), blood glucose coefficient of variation (%) (28.86 (22.70, 34.83) vs 29.80 (23.47, 36.13), P<0.01), maximum blood glucose fluctuation (mmol/L) (9.30 (6.20, 13.10) vs 10.10 (7.00, 14.40), P<0.01) and nosocomial infection (5.42% vs 8.05%, P<0.05) were all lower among participants in the team management group. In addition, the LOS (P<0.001) and hospital costs (P<0.001) of participants were lower in the team management group.
CONCLUSION
In-hospital blood glucose team management combined with a network blood glucose monitoring system effectively improved the blood glucose control and fluctuation levels of participants who were admitted to noncritical care units, thereby reducing LOS and hospital cost.
目的
提供一种新的院内血糖团队管理系统，结合网络血糖监测系统，分析其对非重症监护病房高血糖患者血糖控制的效果。
方法
将非重症监护病房的高血糖患者分为两组，分别接受医院血糖管理团队的主动干预和常规会诊组的常规会诊。通过比较两种血糖管理策略，选择住院时间（ LOS ）更短、住院费用更低的更好方法。
结果
与常规会诊组相比，团队管理组的高血糖检出率（ 18.49% 比 16.17% ， P<0.01 ）和糖化血红蛋白（ 51.53% 比 30.97% ， P<0.01 ）更高，高血糖发生率（ 59.24% 比 61.59% ， P<0.01 ）、严重高血糖（ 3.56% 比 5.19% ， P<0.01 ）和临床显著低血糖（ 0.26% 比 0.35% ， P<0.05 ）发生率更低。同时，血糖漂移（ mmol/L ）（ 2.50 （ 1.83 ， 3.25 ）比 2.76 （ 2.01 ， 3.57 ）， P<0.01 ）、血糖变异系数（ % ）（ 28.86 （ 22.70 ， 34.83 ）比 29.80 （ 23.47 ， 36.13 ）， P<0.01 ）、最大血糖波动（ mmol/L ）（ 9.30 （ 6.20 ， 13.10 ）比 10.10 （ 7.00 ， 14.40 ）， P<0.01 ）和医院感染（ 5.42% 比 8.05% ， P<0.05 ）均低于团队管理组。此外，团队管理组的住院时间（ P<0.001 ）和住院费用（ P<0.001 ）均低于团队管理组。
结论
院内血糖团队管理结合网络血糖监测系统，可有效改善非重症监护病房患者的血糖控制和波动水平，降低住院时间和住院费用。
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