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1 726例住院患者糖代谢情况回顾性分析
谢俊豪1,陈剑伟2,宋敬云1,霍翠兰1,黄勤1*
0
(1. 第二军医大学长海医院内分泌科, 上海 200433;
2. 第二军医大学长海医院医教部, 上海 200433
*通信作者)
摘要:
目的 分析不同科室住院患者的血糖水平及相关资料,为院内血糖规范化管理提供依据。方法 回顾性分析2014年11月我院9个科室1 726例出院患者资料,包括入院时血糖、各项代谢指标、住院天数及住院费用等,分析血糖异常情况及相关影响因素。结果 有99.19%(1 712/1 726)的患者在住院期间至少检测过一次血糖。依据患者既往史、入院时或住院期间血糖检查结果,血糖异常者占42.76%(738/1 726);除内分泌科(73.79%,76/103)外,老年病科(54.17%,13/24)和胰腺外科(50.54%,93/184)血糖异常患者较多。新发血糖异常者393例,占分析患者的22.77%,其住院时间及住院费用等均高于既往确诊糖尿病及糖调节受损(IGR)与血糖正常患者(P<0.01)。既往确诊糖尿病及IGR患者血三酰甘油(TG)及血尿素(BUN)水平均高于血糖正常及新发血糖异常患者(P<0.05,P<0.01);既往确诊糖尿病及IGR与新发血糖异常患者血高密度脂蛋白胆固醇(HDL-C)水平均低于血糖正常患者(P<0.01),但既往确诊糖尿病及IGR与新发血糖异常患者间差异无统计学意义。结论 住院期间新发高血糖不容忽视,应加强对高危人群入院及住院期间的血糖监测,并规范高血糖的院内管理。
关键词:  回顾性研究  院内血糖管理  住院费用  住院时间
DOI:10.16781/j.0258-879x.2017.01.0034
投稿时间:2016-06-16修订日期:2016-09-23
基金项目:国家自然科学基金(81471038),中华医学会专项基金(13061080493).
Glucose metabolism in hospitalized patients: a retrospective analysis of 1 726 cases
XIE Jun-hao1,CHEN Jian-wei2,SONG Jing-yun1,HUO Cui-lan1,HUANG Qin1*
(1. Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Medical Education, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To analyze the blood glucose levels and related data of inpatients of different clinical departments, so as to provide a basis for normalized management of blood glucose in hospital. Methods Medical records of 1 726 discharged patients from 9 different clinical departments of Changhai Hospital in November 2014 were retrospectively analyzed using medical record inquiry system. The data included admission blood glucose, metabolic indexes, hospital stay and hospitalization expenses. The abnormal blood glucose and related factors were analyzed. Results We found that 99.19% (1 712) of the 1 726 inpatients had their blood glucose monitored once at least. According to their past medical history and blood glucose levels on admission or during hospitalization, 42.76% (738) patients had pathoglycemia. Endocrinology department (73.79%,76/103), geriatrics department (54.17%, 13/24) and pancreatic surgical department (50.54%, 93/184) had more pathoglycemia patients than other departments. The patients with newly discovered pathoglycemia (393) accounted for 22.77% of the inpatients, and the hospital stay and hospitalization expenses in these patients were significantly higher than patients with diabetes and impaired glucose regulation (IGR) and those with normal blood glucose (P<0.01). The levels of serum triglyceride (TG) and blood urea (BUN) of diabetic and IGR inpatients were significantly higher than patients with newly discovered high glucose and normal glucose (P<0.01); the levels of high density lipoprotein cholesterol (HDL-C) in diabetic and IGR inpatients and those with newly discovered pathoglycemia were significantly lower than that in those with normal blood glucose (P<0.01), but there was no significant difference between the former two groups. Conclusion Newly discovered hyperglycemia during hospitalization should not be overlooked. The blood glucose monitoring of high risk population should be reinforced on admission and during hospitalization, and a standard management of hyperglycemia should be established.
Key words:  retrospective studies  blood glucose management of inpatients  hospitalization costs  hospital stay