非内分泌科住院高血糖患者血糖管理现状调查研究

Investigation and Study on the Management of Patients with Hyperglycemia in Non-Endocrinology Departments

摘要: 目的：以非内分泌科收治的高血糖患者为研究对象，探讨其血糖管理现状，并对内分泌科会诊管理模式和科室自我管理模式下血糖管理质量进行评价。方法：收集浙江省人民医院2020-07-12至2020-07-18期间出院的非内分泌科住院患者(1802例)，对其空腹静脉血糖进行调查，分析血糖管理情况主要包括糖化血红蛋白测定情况、末梢血糖监测、日均血糖监测频次、是否邀请内分泌科会诊调整血糖、糖代谢异常诊断、告知患者内分泌科随诊、饮食教育等，是否行手术治疗、术前准备时间、住院时间、住院费用、出院时空腹血糖达标情况。结果：高血糖患者在住院时间、住院费用上明显高于血糖正常患者(P < 0.05)。内分泌科会诊率仅占14.0%，未能满足院内血糖管理的需求。内分泌科会诊管理模式在血糖管理较多方面优于科室自我管理模式(P < 0.05)。围手术期患者血糖管理质量较差，其高血糖患者住院时间、住院费用、术前准备时间均高于血糖正常患者。结论：非内分泌科住院患者高血糖检出率较高，血糖管理水平有待加强，内分泌科会诊管理优于科室自我管理。应强化非内分泌科医护人员的血糖管理意识，加强与内分泌科的联系合作，共同提高血糖管理质量。

Abstract: Objective: To investigate the current situation of hyperglycemic patients admitted to the non- en-docrinology departments of Zhejiang Provincial People’s Hospital, and to evaluate the quality of blood glucose management under the consultation management mode of endocrinology depart-ment and departmental self-management mode. Methods: Patients (1802 patients) from non- en-docrinology departments who were discharged from the hospital from July 12, 2020 to July 18, 2020 were selected. Investigate fasting blood glucose, HbA1c measurement, fingertip blood glucose monitoring, endocrinology consultation, hospitalization days and expenses, as well as whether the blood glucose reached the standard, diagnosis and notice at discharge of patients with hyperglyce-mia, and then conduct statistic analysis. Result: There were significant differences between hyper-glycemia patients and normal blood glucose patients in hospitalization days and expenses (P < 0.05). The consultation rate of the endocrinology department only accounted for 14.0%, which failed to meet the demand of blood glucose management in the hospital. The consultative manage-ment mode of the endocrinology department was better than the departmental self-management mode in many aspects of blood glucose management (P < 0.05). The quality of perioperative blood glucose management is poor. Perioperative hyperglycemic patients had higher hospitalization days and expenses and preoperative preparation days than normal glucose patients. Conclusion: The rate of hyperglycemia detection is high in inpatients with non-endocrinology and the level of blood glucose management needs to be strengthened. The consultation management of non-endocrinology department is better than the self-management of department. The awareness of blood glucose management among non-endocrine medical staff should be strengthened, and the cooperation with endocrine departments should be enhanced to jointly improve the quality of glu-cose management.