危重患者持续静静脉血液滤过时血糖监测的影响因素研究_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

虞竹溪 , 顾勤 , 刘宁 , 杨朴强

Corresponding author：

Keywords：

持续静静脉血液滤过; 危重症; 血糖监测

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的观察危重患者持续静静脉血液滤过( CVVH) 过程中血糖监测的影响因素。方法选择CVVH治疗的危重患者30 例, 根据其入选时的循环状态将患者分为休克组和非休克组, 同时监测两组患者动脉血糖、末梢血糖及CVVH 导管动脉端血糖, 比较同一时点各部位血糖监测值。结果所有患者动脉血糖值与末梢血糖值比较有显著差异( P lt; 0. 05) , 动脉血糖值与CVVH 导管动脉端血糖值差异无统计学意义( P gt; 0. 05) , 且二者存在明显相关性( r = 0. 989, P lt; 0. 001) , 末梢血糖值与CVVH导管动脉端血糖值差异有统计学意义( P lt;0. 05) ; 休克组末梢血糖值较动脉血糖值低, 差异有统计学意义( P lt; 0. 05) , 非休克组末梢血糖值与动脉血糖值差异无统计学意义( P gt;0. 05) 。结论危重患者末梢血糖监测值偏低, 该差异在休克患者中更加明显; CVVH时可通过导管动脉端采血监测血糖。

Citation： 虞竹溪,顾勤,刘宁,杨朴强. 危重患者持续静静脉血液滤过时血糖监测的影响因素研究. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(1): 85-87. doi: Copy

1.	Van den Berghe G,WilmerA,Hermans G,et al.Intensive insulin therapy in the medical ICU. N Engl J Med, 2006,354:449-461.
2.	Author L,S Finfer S.Intensive versus conventional glucose control in critically ill patients.N Engl J Med,2009;360:1283-1297.
3.	张久之,万献尧,吴向东.急性脑血管病机械通气患者院内死亡的预后因素分析.中国呼吸与危重监护杂志,2008,7:281-285.
4.	Critchell CD,Savarese V,Callahan A,et al.Accuracy of bedside capillary blood glucose measurements in critically ill patients.Intensive Care Med,2007,33:2079-2084.
5.	Cottingham CA.Resuscitation of traumatic shock: a hemodynamic review. AACN Adv Crit Care,2006,17:317-326.
6.	Van den Berghe G.How does blood glucose control with insulin save lives in intensive care? J Clin Invest,2004,114:1187-1195.
7.	Coursin DB,Connery LE,Ketzler JT. Perioperative diabetic and hyperglycemic management issues.Crit Care Med,2004,32:S116-S125.
8.	Finkielman JD,Oyen LJ,Afessa B,et al. Agreement Between Bedside Blood and Plasma Glucose Measurement in the ICU Setting.Chest,2005,127:1749-1751.
9.	Desachy A,Vuagnat AC,Ghazali AD,et al. Accuracy of Bedside Glucometry in Critically Ill Patients: Influence of Clinical Characteristics and Perfusion Index.Mayo Clin Proc,2008,83:400-405.
10.	Van den Berghe G,Wouters P,Weekers F,et al.Intensive insulin therapy in critically ill patients.N Engl J Med,2001,345:1359-1367.
11.	谢平初,陆家齐,孙大铭,等.猪内毒素休克外周与内脏微循环灌注的动态变化.中国危重病急救医学,1999,11:718-720.
12.	季大玺,谢红浪,黎磊石.连续性血液净化与非肾脏疾病.中国危重病急救医学,2001,13:5-9.
13.	Read JL,Cheng EY.Intensive insulin therapy for acute hyperglycemia. AACN Adv Crit Care,2007,18:200-212.
14.	Harper J,Glucose control in the intensive care unit: how it is done. Proc Nutr Soc,2007,66:362-366.

1. Van den Berghe G,WilmerA,Hermans G,et al.Intensive insulin therapy in the medical ICU. N Engl J Med, 2006,354:449-461.
2. Author L,S Finfer S.Intensive versus conventional glucose control in critically ill patients.N Engl J Med,2009;360:1283-1297.
3. 张久之,万献尧,吴向东.急性脑血管病机械通气患者院内死亡的预后因素分析.中国呼吸与危重监护杂志,2008,7:281-285.
4. Critchell CD,Savarese V,Callahan A,et al.Accuracy of bedside capillary blood glucose measurements in critically ill patients.Intensive Care Med,2007,33:2079-2084.
5. Cottingham CA.Resuscitation of traumatic shock: a hemodynamic review. AACN Adv Crit Care,2006,17:317-326.
6. Van den Berghe G.How does blood glucose control with insulin save lives in intensive care? J Clin Invest,2004,114:1187-1195.
7. Coursin DB,Connery LE,Ketzler JT. Perioperative diabetic and hyperglycemic management issues.Crit Care Med,2004,32:S116-S125.
8. Finkielman JD,Oyen LJ,Afessa B,et al. Agreement Between Bedside Blood and Plasma Glucose Measurement in the ICU Setting.Chest,2005,127:1749-1751.
9. Desachy A,Vuagnat AC,Ghazali AD,et al. Accuracy of Bedside Glucometry in Critically Ill Patients: Influence of Clinical Characteristics and Perfusion Index.Mayo Clin Proc,2008,83:400-405.
10. Van den Berghe G,Wouters P,Weekers F,et al.Intensive insulin therapy in critically ill patients.N Engl J Med,2001,345:1359-1367.
11. 谢平初,陆家齐,孙大铭,等.猪内毒素休克外周与内脏微循环灌注的动态变化.中国危重病急救医学,1999,11:718-720.
12. 季大玺,谢红浪,黎磊石.连续性血液净化与非肾脏疾病.中国危重病急救医学,2001,13:5-9.
13. Read JL,Cheng EY.Intensive insulin therapy for acute hyperglycemia. AACN Adv Crit Care,2007,18:200-212.
14. Harper J,Glucose control in the intensive care unit: how it is done. Proc Nutr Soc,2007,66:362-366.

Chinese Journal of Respiratory and Critical Care Medicine

危重患者持续静静脉血液滤过时血糖监测的影响因素研究

Abstract Full text Figures/Tables Video References Cited by

Format

Content