糖尿病患者急性卒中后血糖监测及管理的最佳证据总结

doi:10.16460/j.issn1008-9969.2021.15.042

摘要/Abstract

摘要： 目的检索有关糖尿病患者急性卒中后血糖监测及管理的相关证据,并汇总最佳证据供临床参考。方法根据循证护理的方法,按照“6S”证据模型,利用计算机检索国内外有关糖尿病患者急性卒中后血糖监测及管理的临床决策、指南、系统评价、随机对照试验、证据总结和专家共识,由2名经过循证护理系统化培训的研究员对纳入的文献进行独立评价,并对通过质量评价的文献进行证据提取。结果共纳入13篇文献,其中临床决策1篇、指南6篇、系统评价1篇、随机对照试验2篇、证据总结1篇和专家共识2篇,并从中汇总23条证据,最后从6个维度总结了14条最佳证据。结论对于糖尿病患者急性卒中后的血糖管理要遵循个性化和多样化原则,在降糖治疗的同时要充分考虑患者的实际情况,为其制定个性化的降糖方案;同时也要注意低血糖带来的危害,加强血糖监测,避免低血糖的发生。

关键词: 糖尿病, 急性卒中, 血糖管理, 循证护理学, 最佳证据

Abstract: Objective To retrieve the relevant evidence of monitoring and management of blood glucose after acute stroke in diabetic patients and summarize the best evidence for clinical reference. Methods With the method of evidence-based nursing, in accordance with the "6s" evidence model, we collected clinical decision , guideline, systematic review, randomized controlled trial, evidence summaries and expert consensus about blood sugar monitoring and management in diabetes patients with acute stroke at home and abroad. Two researchers after systematic training of evidence-based nursing evaluated the quality of the literature and extracted the evidence. Results Thirteen articles were included: 1 clinical decision, 6 guidelines, 1 systematic evaluation, 2 randomized controlled trials, 1 evidence summary and 2 expert consensus. Totally 23 pieces of evidence were summarized, and 14 pieces of best evidence were finally summarized from 6 dimensions. Conclusion Blood glucose management after acute stroke in diabetic patients should be individualized and diversified. In addition to hypoglycemic treatment, the actual situation of the patients should be fully considered and personalized hypoglycemic plan should be formulated. At the same time, we should also pay attention to the harm caused by hypoglycemia, strengthen blood glucose monitoring, and avoid the occurrence of hypoglycemia.

Key words: diabetes, acute stroke, management of blood glucose, evidence-based nursing, best evidence

中图分类号:

R473.58

卢舒颖, 刘宁, 廉民学. 糖尿病患者急性卒中后血糖监测及管理的最佳证据总结[J]. 护理学报, 2021, 28(15): 42-47.

LU shu-ying, LIU ning, LIAN Min-xue. Best Evidence Summary of Blood Glucose Monitoring and Management in Diabetes Patients with Acute Stroke[J]. Journal of Nursing, 2021, 28(15): 42-47.

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