重症患者床旁血糖监测的准确性评价及影响因素分析  

Evaluation of the accuracy of blood glucose monitoring in critically ill patients and analysis of influence factor on accuracy

作　　者：马旭辉 王后兴 林建[3] 

机构地区：[1]浙江省奉化市人民医院重症科,浙江奉化315002 [2]浙江省宁波市鄞州区第二医院重症医学科,浙江宁波315000 [3]中南大学,湖南长沙410000

出　　处：《中国医药导报》2013年第27期166-168,共3页China Medical Herald

基　　金：高等学校博士学科点专项科研基金(编号20080 5331018)

摘　　要：目的探讨重症患者床旁实施快速血糖监测的准确性及影响准确性的相关因素。方法选择浙江省奉化市人民医院重症科2010年3月～2011年3月收治的80例重症患者,并采取葡萄糖脱氢酶法和葡萄糖氧化酶法测定患者的静脉血与动脉血以及指尖血的血糖含量,并与实验室标准法测定的血糖值进行对比,分析两种方法测定的准确性及影响测定值的相关因素。结果葡萄糖氧化酶法测定患者静脉血和动脉血以及指尖血的血糖值均明显的高于实验室标准法的测定值,差异有统计学意义(P<0.05);葡萄糖氢化酶法测定患者静脉血和动脉血以及指尖血的血糖值与实验室标准法的测定值比较差异无统计学意义(P>0.05)。葡萄糖氧化酶法测定静脉血和动脉血以及指尖血的误差率均明显的高于葡萄糖氢化酶法测定静脉血和动脉血以及指尖血的误差率,差异有统计学意义(P<0.05)。对影响床旁快速血糖监测的准确性因素分析,血糖低和低APACHEⅡ评分以及低血细胞比容均是影响床旁快速血糖监测准确性的重要因素。结论临床中重症患者的血糖很容易受到其他因素的影响,从而影响床旁快速血糖监测的准确性,因此应采取针对性的措施,提高测定的准确性。Objective To investigate the monitoring accuracy of implementation of fast blood glucose monitoring for critically ill patients, and analyze the influence factor. Methods 80 cases of critically ill patients treated in the Peo- ple＇s Hospital of Fenghua City in Zhejiang Province from March 2010 to March 2011 were selected. The blood glucose levels of venous blood, arterial blood and fingertip blood were detected by glucose dehydrogenase method and glucose oxidase method, which were compared with the blood glucose value detected by the standard laboratory method. The accuracy of two methods and influence factors were analyzed. Results Blood glucose values of venous, arterial and fin- gertip blood detected by the method of glucose oxidase were significantly higher than detected by standard laboratory method, the differences were statistically significant （P 〈 0.05）, and there was no statistically significant difference be- tween blood glucose values detected by hydrogenated enzymatic and standard laboratory method （P 〉 0.05）. The error of glucose oxidase method was significantly higher than the error of hydrogenation of glucose enzymatic, the difference was statistically significant （P 〈 0.05）. The factors influenced on accuracy of rapid bedside glucose monitoring were an- alyzed, low blood sugar, low APACHE Ⅱ score and low hematocrit were affected the accuracy of rapid bedside glu- cose monitoring. Conclusion In clinic, the blood sugar of critically ill patients is easily affected by other factors, which will also affect the accuracy of rapid bedside glucose monitoring, therefore take corresponding measures should be tak- en in clinical practice, to improve the determination accuracy.

关 键 词：重症患者 床旁血糖监测 准确性 影响因素 

分 类 号：R446.11[医药卫生—诊断学]