肠内和肠外营养期间高血糖的管理刘晓燕ppt课件.pptVIP

Diabetes 肿瘤外科：刘晓燕 朱月娟 2014.08.23 汇报提要 文章摘要 肠内营养高血糖的管理 汇报总结 肠外营养高血糖的管理 Tittle（文题） 肠内和肠外营养期间高血糖的管理 IF=2.496 Curr Diab Rep.2013V13N1:155-62 Abstract(文章摘要) Abstract(文章摘要) 高血糖是住院患者肠内肠外养常见并发症 与增加死亡风险和感染并发症有关 没有具体的推荐指南和有效的高血糖管理策略 a frequent complication associated with an increased risk of death and infectiouscomplications. no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia Managing should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy 高血糖的管理应包括碳水化合物含量的优化和静脉注射或皮下注射胰岛素治疗的管理 Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulinstrategy in patients receiving enteral feedings. 在接受肠内喂养的患者，长效胰岛素皮下注射与预定的或纠正剂量的短效胰岛素策略优于滑动刻度的胰岛素策略。 The administration ofcontinuous insulin infusion and insulin addition to nutrition bag are efficient approaches to controlhyperglycemia during parenteral nutrition. 在肠外营养连续输注胰岛素和胰岛素加入营养袋是控制高血糖有效的方法。 空腹血糖7.0mmol/l 随机血糖11.1mmol/l Introduction（简介） 在城市社区医院，无论是否有糖尿病史的病人：32-38%的病人发现有高血糖 [1,2] 美国入院病人中20-30%将被诊断为糖尿病[2,3] Cook CB, Kongable GL, Potter DJ, et al. Inpatient glucose control:a glycemic survey of 126 U.S. hospitals. J Hospital Med. 2009;4:E7–E14. Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–82. 3.Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003;26:1421–6. In urban community hospitals,hyperglycemia defined was observed in 32–38 % of patients with and withoutdiabetes history [2, 3]. Up to 20 % to 30 % of patients admitted to hospitals in the United States will have a known diagnosis of diabetes mellitus [3, 4] 50% 30% 营养支持的高血糖 患病率高[4–7] 4. Pleva M, Mirtallo JM, Steinberg