扫描式葡萄糖监测系统联合胰岛素泵对骨科围手术期糖尿病病人血糖控制的效果观察

胡红艳; 熊圣喜; 李敏; 蒋威; 施冠华; 黄俊梅; 胡小磊

doi:10.13898/j.cnki.issn.2097-5252.2025.11.022

扫描式葡萄糖监测系统联合胰岛素泵对骨科围手术期糖尿病病人血糖控制的效果观察

Study on the effects of flash glucose monitoring system combined with continuous subcutaneous insulin infusion on glycemic control of perioperative diabetic patients in orthopedic department

摘要

摘要:
目的探讨扫描式葡萄糖监测系统(FGMS)联合胰岛素泵(CSII)在骨科围手术期糖尿病病人中应用的效果。
方法选取骨科收治需行3~4级手术治疗的2型糖尿病病人为研究对象，随机分为2组: 观察组75例，采用CSII+FGMS方案管理血糖；对照组50例，采用每天多次胰岛素注射(MDI)+自我血糖监测(SMBG)方案管理血糖。收集病人一般资料、生化指标及临床疗效观察指标，包括血糖达标时间、总住院时间以及FGMS相关指标平均血糖波动幅度(MAGE)、血糖变异度(CV)、血糖标准差(SDBG)、总住院费用、日平均费用、糖尿病治疗满意度问卷(DTSQ)评分等；观察2组间临床疗效、经济效益及治疗满意度差异。
结果 2组降糖方案实施后，MAGE、CV、SDBG均低于血糖控制前(P < 0.05~P < 0.01)；术后3 d，观察组MAGE、CV、SDBG均明显低于对照组(P < 0.01)。观察组病人血糖达标时间、总住院时间、DTSQ-高血糖相关评分及DTSQ-低血糖相关评分低于对照组(P < 0.01)，而观察组日平均费用、DTSQ-满意度相关评分高于对照组(P < 0.01)。
结论 CSII+FGMS联合使用对于骨科糖尿病病人围手术期的血糖管理更加有效、稳定、安全，并且性价比高。

Abstract:
Objective To explore the effects of flash glucose monitoring system(FGMS) combined with continuous subcutaneous insulin infusion (CSII) in orthopedic perioperative patients with diabetes mellitus.
Methods The type 2 diabetes mellitus patients scheduled by grade 3-4 surgical treatment in orthopedics were selected as the research subjects, and randomly divided into two groups. The blood glucose in the observation group were managed using CSII+FGMS regimen(75 cases), and the blood glucose levels in the control group were managed using a combination of multiple daily insulin injections(MDI) and self-monitoring of blood glucose(SMBG) (50 cases). The general data, biochemical indicators and clinical efficacy observation indicators including time of reaching blood glucose standard, total hospital stay, FGMS related indicators mean amplitude of glycemic excursions (MAGE), blood glucose variability(CV), standard deviation of blood glucose (SDBG), total hospital cost, average daily cost and diabetes treatment satisfaction questionnaire(DTSQ) scores in two groups were collected. The differences in the clinical efficacy, economic benefits and treatment satisfaction were compared between two groups.
Results After the implementation of the two hypoglycemic regimens, the levels of MAGE, CV and SDBG in two groups were lower than those before control(P < 0.05 to P < 0.01). After 3 days of operation, the levels of MAGE, CV and SDBG in the observation group were significantly lower than those in control group(P < 0.01). The time to reach the target blood glucose level, total hospital stay, DTSQ-hyperglycemia-related score and DTSQ-hypoglycemia-related score in the observation group were lower than those in control group(P < 0.01), while the average daily cost and DTSQ-satisfication-related score in the observation group were higher than those in control group(P < 0.01).
Conclusions The combined use of CSII and FGMS is more effective, stable, safe and cost-effective for perioperative blood glucose management in orthopedic diabetic patients.

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