摘要
外科重症病人普遍存在应激性高血糖,其预示或导致不良预后。近年研究显示强化胰岛素治疗(intensive insulin therapy,IIT)的益处,医疗机构纷纷效仿,但新的问题随之产生,如IIT显著增加低血糖的发生率,难以复制前期的优势结果等。人们开始对IIT产生怀疑,该如何面对关于控制血糖的各种争议?首先,争议是一种进步,不必因此而彻底否定高血糖对机体的损害,忽视或者彻底摒弃血糖控制。再者,现阶段应掌握血糖控制的"度"。实际工作中了解血糖控制并不仅是应用胰岛素控制血糖,必须注意其他影响血糖的因素,制定完备的方案。同时鉴于目前IIT还有许多悬而未决的问题,需要设计更为严谨的研究加以阐述。
Stress hyperglycemia develops commonly in surgical critically ill patients and it may indicate or even cause poor prognosis. Benefits of intensive insulin therapy （IIT） were demonstrated by many recent studies. As liT is administered by more and more institutions. Questions and controversies have been raised in terms of the safety and efficacy of the therapy. The tight glycemic control is still important especially in surgical intensive care, though some of the reports showed negative results. The intensity of glycemic control should be optimal. It＇s essential to understand that insulin therapy is not the only way to maintain normoglycemia and other factors which are involved in glucose metabolism should also be noticed in glycemic control plans. More concise studies are still need to provide further guide for the best practice of the implementation of ITT.
出处
《中国实用外科杂志》
CSCD
北大核心
2010年第11期926-930,共5页
Chinese Journal of Practical Surgery
关键词
外科重症病人
应激性高血糖
强化胰岛素治疗
surgical critically ill patients
stress hyperglycemia
intensive insulin therapy
