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连续血糖监测系统在胰腺切除患者中的准确性和可行性

Accuracy and feasibility of continuous glucose monitoring system in pancreatectomy patients.

作者信息

Choi Yoo Jin, Jeon Su Min, Yu Sehyeon, Jo Hye-Sung, Kim Dong-Sik, Yu Young-Dong

机构信息

Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University College of Medicine, Seoul, Korea.

Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea.

出版信息

Langenbecks Arch Surg. 2025 Jan 10;410(1):32. doi: 10.1007/s00423-024-03601-8.

Abstract

PURPOSE

Pancreatectomy patients often experience challenging fluctuations in blood glucose levels; therefore, they require a reliable monitoring system. This study aimed to determine the accuracy and acceptability of a continuous glucose monitoring (CGM) system compared with the intermittent capillary glucose test in patients who have undergone pancreatectomy.

METHODS

Thirty non-diabetic pancreatectomy patients participated. We used the FreeStyle Libre Flash Glucose Monitoring System (Abbott Diabetes Care) for continuous interstitial glucose monitoring. Capillary reference glucose levels were checked four times daily. Accuracy was checked using the Clarke Error Grid.

RESULTS

The mean age of the participants was 56.8 ± 12.0 years, of whom 61.3% underwent pancreaticoduodenectomy and 38.7% underwent distal pancreatectomy. Three patients developed pancreatogenic diabetes after pancreatectomy. The clinical accuracy of continuous glucose monitoring compared with capillary glucose was 43.9% in Zone A (clinically accurate zone) and 99.8% in Zone A + B (low risk of error) of the Clarke Error Grid. No device-related adverse events were reported. Patients rated favorable user acceptability on the questionnaire.

CONCLUSION

This pilot study demonstrated that the CGM device is accurate and safe for patients who underwent pancreatectomy, with favorable user acceptability. Despite these challenges, the study proposes that the CGM device is beneficial for monitoring glucose levels after discharge in patients with impaired glucose levels following pancreatectomy.

摘要

目的

胰腺切除术后患者常经历血糖水平的剧烈波动,因此他们需要一个可靠的监测系统。本研究旨在确定与间歇性毛细血管血糖检测相比,连续血糖监测(CGM)系统在胰腺切除术后患者中的准确性和可接受性。

方法

30例非糖尿病胰腺切除术后患者参与研究。我们使用FreeStyle Libre Flash葡萄糖监测系统(雅培糖尿病护理公司)进行连续的组织间液葡萄糖监测。每天检测4次毛细血管参考血糖水平。使用克拉克误差网格检查准确性。

结果

参与者的平均年龄为56.8±12.0岁,其中61.3%接受了胰十二指肠切除术,38.7%接受了远端胰腺切除术。3例患者在胰腺切除术后发生胰源性糖尿病。与毛细血管血糖相比,连续血糖监测在克拉克误差网格的A区(临床准确区)的临床准确性为43.9%,在A+B区(误差风险低)为99.8%。未报告与设备相关的不良事件。患者在问卷中对用户可接受性给予了好评。

结论

这项初步研究表明,CGM设备对胰腺切除术后患者准确且安全,具有良好的用户可接受性。尽管存在这些挑战,但该研究提出,CGM设备有利于监测胰腺切除术后血糖水平受损患者出院后的血糖水平。

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