摘要
血糖异常是重症患者急性期最常见的代谢紊乱之一,营养治疗的启用可能进一步加重高血糖与血糖的波动。过高血糖、低血糖和血糖变异都是影响重症患者病死率的独立危险因素。糖化血红蛋白、血糖变异系数、达目标血糖范围时间等指标可用于评价血糖控制优劣。针对不同的重症患者群体,分层优化血糖控制目标,并结合计算机智能化技术个体化地制定血糖管理方案,同时选择合适的喂养方式,有助于血糖调控和改善临床预后。本文就近年来针对重症患者血糖目标及控制评价指标,血糖监测技术与管理方案,肠内营养的喂养方式对血糖的影响等方面的进展做出阐述。
Dysglycemia is one of the most common metabolic disturbances in the acute phase of critically ill patients.The initiation of nutritional therapy may further promote the fluctuation of blood glucose.Hyperglycemia,hypoglycemia and glucose variability are independent risk factors for increased mortality among critically ill patients.Glycated hemoglobin,coefficient of glucose variation,time to targeting blood glucose range are useful measurements for evaluating the quality of glucose control.For different groups of critically ill patients,stratified optimization of glucose control goals,combined with computerized technology to formulate individualized glucose management,and selection of appropriate feeding methods,will benefit glucose control and improve clinical outcomes.This paper expounds the progress in blood glucose targets and control evaluation indicators,blood glucose monitoring technology and management scheme,and influence of enteral nutrition feeding mode on blood glucose in recent years.
作者
谈莉
周华
Tan Li;Zhou Hua(Department of Critical Care Medicine,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《中华重症医学电子杂志》
CSCD
2022年第4期304-309,共6页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
关键词
营养治疗
血糖调控
血糖变异
Nutritional therapy
Glucose control
Glucose variability
