新型冠状病毒肺炎疫情期间脑卒中合并糖尿病患者院内血糖管理新模式探索  

Exploration of a new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019

作　　者：黄婧[1] 叶文春[1] 方向明[1] 谯艳[1] 杨白林[1] 刘小英[1] 漆晓玲[1] HUANG Jing;YE Wenchun;FANG Xiangming;QIAO Yan;YANG Bailin;LIU Xiaoying;QI Xiaolin(Department of Endocrinology,Mianyang Central Hospital,Sichuan 621000,P.R.China)

机构地区：[1]绵阳市中心医院内分泌科,四川绵阳621000

出　　处：《华西医学》2021年第1期30-34,共5页West China Medical Journal

基　　金：四川省卫生信息学会科研课题资助项目(2019006)。

摘　　要：目的探讨新型冠状病毒肺炎疫情期间脑卒中合并糖尿病患者院内血糖管理新模式的应用效果。方法选择2019年10月1日—2020年4月12日在绵阳市中心医院住院并经内分泌科会诊的脑卒中合并2型糖尿病患者120例,将2019年10月1日—2020年1月19日采用传统会诊模式进行血糖管理的患者归为对照组(60例),2020年1月20日—4月12日采用远程血糖管理虚拟病房联合视频会诊模式管理的患者归为观察组(60例),比较两组患者的基本情况、血糖达标时间、会诊完成时间、血糖相关数据准确率、会诊满意率、血糖达标率、低血糖发生率、血糖波动情况(血糖水平标准差、最大血糖波动幅度)、院内感染发生率、糖尿病诊疗相关费用和平均住院费用。结果两组患者的基本情况差异无统计学意义(P>0.05)。观察组患者的血糖达标时间[(5.38±2.16)vs.(8.18±2.63)d]、会诊完成时间[(4.33±1.51)vs.(17.97±3.23)h]、低血糖发生率(6.67%vs.21.67%)、血糖水平标准差[(2.16±0.34)vs.(2.52±0.34)mmol/L]和最大血糖波动幅度[(5.72±1.36)vs.(6.34±1.51)mmol/L]低于对照组,血糖相关数据准确率(100.00%vs.83.33%)、会诊满意率(93.33%vs.73.33%)和血糖达标率(88.33%vs.70.00%)高于对照组,差异有统计学意义(P<0.05);两组患者的院内感染发生率、糖尿病诊疗相关费用和平均住院费用差异无统计学意义(P>0.05)。结论新型冠状病毒肺炎疫情期间,脑卒中合并糖尿病患者中远程血糖虚拟病房联合视频会诊模式应用效果较好,具有一定的可行性和临床推广价值。Objective To explore the application effect of the new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019.Methods A total of 120 patients with stroke and diabetes mellitus who were admitted to Mianyang Central Hospital and were consulted by the Department of Endocrinology between October 1 st 2019 and April 12 th 2020 were recruited.Patients who used the traditional consultation model for blood glucose management between October 1 st 2019 and January 19 th 2020 were classified as the control group(60 cases).Patients who were managed by the virtual ward of remote blood glucose management combined with the video consultation mode between January 20 th 2020 and April 12 th 2020 were classified as the observation group(60 cases).The basic conditions,the time to reach target blood glucose,the completion time of the consultation,the accuracy of blood glucose related data,the satisfaction rate of the consultation,the rate of reaching target blood glucose,the incidence of hypoglycemia,the blood glucose fluctuation(standard deviation of blood glucose level,maximum blood glucose fluctuation range),the incidence of nosocomial infections,diabetes mellitus diagnosis and treatment related expenses,and average hospitalization expenses of the two groups were compared.Results There was no significant difference in the basic conditions between the two groups of patients(P>0.05).The time to reach target blood glucose[(5.38±2.16)vs.(8.18±2.63)d],completion time of the consultation[(4.33±1.51)vs.(17.97±3.23)h],incidenceof hypoglycemia(6.67%vs.21.67%),standard deviation of blood glucose level[(2.16±0.34)vs.(2.52±0.34)mmol/L]and maximum blood glucose fluctuation range[(5.72±1.36)vs.(6.34±1.51)mmol/L]of the observation group were lower than those of the control group,the accuracy rate of blood glucose related data(100.00%vs.83.33%),satisfaction rate of the consultation(93.33%vs.73.33%)and rate of reaching target blood glucose(88.33%vs.70.00%)o

关 键 词：新型冠状病毒肺炎 脑卒中 糖尿病 血糖管理 

分 类 号：R587.2[医药卫生—内分泌] R743.3[医药卫生—内科学]