ICU病人血糖管理最佳证据总结  

Summary of the best evidence for blood glucose management in ICU patients

作　　者：孙淑青[1] 王建华 崔娟 秦德春[1] SUN Shuqing;WANG Jianhua;CUI Juan;QIN Dechun(Weifang People′s Hospital,Shandong 261041 China)

机构地区：[1]潍坊市人民医院,山东261041

出　　处：《循证护理》2023年第9期1538-1544,共7页Chinese Evidence-Based Nursing

摘　　要：目的:总结重症监护病房(ICU)病人全程血糖管理最佳证据,为ICU医护人员提供血糖管理循证依据。方法:系统检索Up To Date、BMJ Best Practice、the Cochrane Library、乔安娜布里格斯研究所图书馆、美国国立指南库、国际网络指南网、英国国家临床医学研究所指南库、苏格兰学院间指南网、加拿大安大略注册护士协会网站、加拿大医学会临床实践指南、PubMed、EMbase、Springer、ScienceDirect、英国NEWT网站、CINAHL、中国生物医学文献数据库、中国知网、万方数据库、医脉通等数据库、系统评价库中与ICU病人血糖管理有关的文献,包括临床决策、临床实践指南、证据总结、专家共识、随机对照研究。检索时限为自建库至2022年4月30日。由2名研究者独立对文献质量进行评价并提取资料。结果:共纳入文献11篇,包括指南4篇、专家共识5篇、证据总结1篇、随机对照研究1篇。总结的最佳证据包括ICU病人血糖监测方式、末梢血糖监测方法、末梢血糖结果影响因素、血糖控制目标、血糖控制方案、围术期血糖管理、质量控制、效果评价7个方面,共33条。结论:ICU病人全程血糖管理最佳证据总结可为ICU医护人员血糖管理提供循证依据。证据应用人员在进行证据转化时应考虑具体情境,合理选择证据,以便制订符合个体情况的ICU病人血糖管理方案。Objective:To summarize the best evidence of whole-course blood glucose management in intensive care unit(ICU)patients and provide an evidence-based basis for blood glucose management for ICU medical staff.Methods:Literature related to blood glucose management in ICU patients,including clinical decision-making,clinical practice guidelines,evidence summaries,expert consensus,and randomized controlled trials(RCTs)was retrieved from Up To Date,BMJ Best Practice,the Cochrane Library,Joanna Briggs Institute Library,US National Guidelines Repository,International Web Guidelines Network,UK National Institute of Clinical Medicine Guidelines Repository,Scottish Intercollegiate Guidelines Network,Canada Ontario Registered Nurses Association,Canadian Medical Association Clinical Practice Guidelines,PubMed,EMbase,Springer,ScienceDirect,UK NEWT,CINAHL,China Biology Medicine disc(CBMdisc),China National Knowledge Infrastructure(CNKI),WanFang Database,Yimaitong,and other databases,from the establishment of the database to April 30,2022.Two researchers independently evaluated the quality of the literature and extracted data.Results:A total of 11 articles were included,including 4 guidelines,5 expert consensus articles,1 evidence summary,and 1 RCT.The best evidence summarized 7 aspects,including ICU patient blood glucose monitoring method,peripheral blood glucose monitoring method,influencing factors of peripheral blood glucose results,blood glucose control target,blood glucose control plan,perioperative blood glucose management,quality control,and effect evaluation,with a total of 33 items.Conclusion:The summary of the best evidence for whole-course blood glucose management in ICU patients could provide an evidence-based basis for blood glucose management of ICU medical staff.Evidence applicators should consider the specific situation when transforming the evidence and select evidence reasonably in order to formulate a blood glucose management plan for ICU patients that suits individual conditions.

关 键 词：重症监护病房 血糖管理 血糖监测 最佳证据 循证护理 

分 类 号：R472[医药卫生—护理学]