缺血性脑卒中患者高血糖管理的最佳证据总结  

Summary of best evidence for hyperglycemia management in patients with ischemic stroke

作　　者：廖宗峰[1] 易巧利 毛李烨 李玲[1] LIAO Zongfeng;YI Qiaoli;MAO Liye;LI Ling

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉市430000 [2]华中科技大学同济医学院附属同济医院护理部,武汉市430000

出　　处：《中华急危重症护理杂志》2023年第2期172-178,共7页Chinese Journal of Emergency and Critical Care Nursing

基　　金：华中科技大学同济医学院附属同济医院科研基金(2021D03)。

摘　　要：目的检索并总结国内外缺血性脑卒中患者高血糖管理的最佳证据,为制订科学合理的高血糖管理方案提供参考。方法采用PIPOST模式构建循证问题,系统检索PubMed、Webof Science、CochraneLibrary、UpTo-Date、BMJBestPractice、国际指南网、加拿大安大略注册护士协会、英国国家临床医学研究所指南库、苏格兰院际指南网、美国内科医师协会、中国知网、万方数据库、医脉通中有关缺血性脑卒中患者高血糖管理的指南、最佳临床实践信息手册、证据总结、专家共识、系统评价及标准,检索时限为建库至2022年11月,由2名研究者对纳入文献质量进行独立评价,提取相关证据。结果共纳入12篇文献,包括指南7篇、系统评价2篇、专家共识2篇、证据总结1篇,总结26条最佳证据,包括入院评估与处理、院内血糖监测与管理、血糖控制目标、出院指导、非药物干预、药物干预6个方面。结论该研究总结了缺血性脑卒中患者高血糖管理的最佳证据,可为临床医护人员临床实践提供参考。Objective To summarize the best evidence of hyperglycemia management in ischemic stroke patients for formulating a scientific and reasonable hyperglycemia management scheme. Methods According PIPOST model to construct evidence-based questions,we systematically searched Pub Med,Web of Science,Cochrane Library,Up To Date,BMJ Best Practice,GIN,RANO,NICE,SIGN,ACP,CNKI,Wanfang Data,Medlive.cn on the evidence related to hyperglycemia management in ischemic stroke patients,including guidelines,best clinical practice information manuals,evidence summaries,expert consensuses,systematic reviews,and standards. The search time limit was from the establishment of databases to November 2022. Two trained researchers evaluated the quality of the literature,and extracted the evidence. Results A total of 12 articles were included,including 7 guidelines,2 systematic reviews,2 expert consensuses,1 evidence summary. The best evidence included 26 recommendations in 6 aspects,namely admission assessment and management,in-hospital blood glucose monitoring and management,goals of blood glucose control,discharge guidance,non-pharmacological intervention and pharmacological intervention. Conclusion This study summarized the best evidence of hyperglycemia glucose management in ischemic stroke patients,and provided evidence-based references for clinical practice of clinical medical staff.

关 键 词：缺血性卒中 高血糖症 证据总结 循证护理学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]