临床药师参与多学科合作的全院血糖管理模式对围手术期患者血糖控制的影响研究  

Effect of multi-disciplinary cooperative blood glucose management model involving clinical pharmacists on perioperative glucose controls

作　　者：代晶 计成[2] 李林通[2] 葛卫红 张宁[3] 毕艳[3] DAI Jing;JI Cheng;LI Lin-tong;GE Wei-hong;ZHANG Ning;BI Yan(Nanjing Drum Tower Hospital,Clinical College of Xuzhou Medical University,Jiangsu Xuzhou 221004,China;Drum Tower Hospital,Medical College,Nanjing University,Department of Pharmacy,Jiangsu Nanjing 210008,China;Drum Tower Hospital,Medical College,Nanjing University,Department of Endocrinology,Jiangsu Nanjing 210008,China)

机构地区：[1]徐州医科大学鼓楼临床学院,江苏徐州221004 [2]南京大学医学院附属鼓楼医院药学部,江苏南京210008 [3]南京大学医学院附属鼓楼医院内分泌科,江苏南京210008

出　　处：《中国医院药学杂志》2021年第2期215-219,共5页Chinese Journal of Hospital Pharmacy

基　　金：南京大学医院管理研究所管理项目课题(编号:NDYG2019006);“南京药学会-常州四药医院药学科研基金”资助项目(编号:2018YX010)。

摘　　要：目的:探讨临床药师参与多学科合作的全院血糖管理模式对围手术期患者血糖控制状况的影响。方法:构建多学科合作的全院血糖管理工作模式,医院成立由临床药师协调"医药护"多学科合作的全院血糖管理小组,对围手术期患者进行血糖管理,制定治疗协议、参与治疗过程。纳入研究对象120例,随机分为普通会诊管理组和全院血糖管理组,比较2组患者血糖管理效果及不良事件发生情况。结果:2组患者管理3 d后,血糖较入院时均有所降低,全院血糖管理组血糖与普通会诊组比显著降低(P<0.05);全院血糖管理组术前血糖达标率为55%,较普通会诊组的35%显著增加(P<0.05);全院血糖管理组术前等待时间和住院时间分别为(7.7±3.3)d和(13.5±4.1)d,较普通会诊组的(9.2±3.8)d和(16.6±7.2)d,明显缩短(P<0.05);全院血糖管理组的不良事件(高低血糖发生率及术后感染率)有所降低。结论:临床药师参与的多学科合作全院血糖管理模式较普通会诊模式可以更好地控制患者的血糖,提高患者的治疗质量。OBJECTIVE To explore the effect of multidisciplinary cooperative blood glucose management model of clinical pharmacists on blood glucose controls of patients during perioperative period. METHODS A multidisciplinary cooperative working model of blood glucose management was constructed and coordinated by clinical pharmacists to manage blood glucose for perioperative patients,formulate treatment protocols and participate in treatments.A total of 120 patients were recruited and randomly divided into general consultation management group and hospital blood glucose management group.The outcomes and adverse events of two groups were compared. RESULTS After 3-day management,blood glucose dropped after admission.Blood glucose of hospital blood glucose management group was significantly lower than that in general consultation group(P<0.05).As compared with general consultation group,subjects in hospital blood glucose management group demonstrated significant differences in outcome measures.The relevant parameters included preoperative blood glucose compliance rate(55%vs 35%,P<0.05),preoperative waiting time [(7.7±3.3)vs(9.2±3.8)],(P<0.05),length of hospitalization [(13.5±4.1)vs(16.6±7.2),P<0.05],incidence of hypoglycemia(13.3%vs 25%,P>0.05),incidence of hyperglycemia(30%vs 60%,P<0.05)and postoperative infection rate(20% vs 33.3%,P>0.05). CONCLUSION As compared with general consultation mode,multi-disciplinary hospital-wide blood glucose management mode involving clinical pharmacists can better control patient blood glucose and boost the quality of treatment.

关 键 词：多学科合作 全院血糖管理 围手术期 2型糖尿病 

分 类 号：R95[医药卫生—药学]