2025年护士专业知识培训
院内低血糖的防治
汇报人：
◎时间：
院内低血糖的发生率
·普通病房的住院糖尿病病人的低血糖发生率为7.7%
·严重低血糖(2.2mmol/L)的发生率为3-11%
·胰岛素治疗患者发生低血糖的风险较非胰岛素治疗者增加2.5倍以上
·住院期间至少发生一次低血糖者相对于未发生者住院天数增加2.8天
院内低血糖的危害
HypoglycemiaandClinicalOutcomesin
PafientsWithDiabetesHospitalizedintheGeneralWard
美国波士顿的一项关于普通病房
美国波士顿的一项关于普通病房糖尿病患者低血糖情况的研究：
发生低血糖的天数每增加1天，出现的死亡风险增加85.3%,出院1年内死亡风险增加65.8%。
OBJECTIVE—Hypoglycemiaisassociatedwithadverseoutcomesinmixedpopulationsofpatientsinintensivecareunits.ItisnotknownwhetherthesamerisksexistfordiabeticpatientswhoarelessseverelyillInthisstudy,weaimedtodeterminewhetherhypoglycemicepisodesareassociatedwithhighermortalityindiabeticpatientshospitalizedinthegeneralward.
RESEARCHDESIGNANDMETHODS-Thisretrospectivecohortstudyanalyzed4,368admissionsof2,582patientswithdiabeteshospitalizedinthegeneralwardofateachinghospitalbetweenJanuary2003andAugust2004.Theassociationsbetweenthenumberandseverityofhypoglycemic(≤50mg/dll)episoxdlesandinpatientmortality,lengthofstay(LOS),andmortalitywithinIyearafterdischargewereevaluated.
RESULTS—Hypoglycemiawasobservedin7.7%ofadmissions.Inmultivariableanalvsiseachadditionaldaywithhypoglycemiawasassociatedwithanincreaseof85.3%intheoddsofnpatientdeath(P=0009)and65.8%(P=0.0003intheoddsofdcathwithin1yearfromdischarge.Theoddsofinpatientdeathalsorosethreefoldlorevery10mgdldecreaseintheTowestbloodglucoseduringhospitalization(P=0.0058).LOSincreasedby2.5daysforeachdaywithhypoglycemia(P0.0001).
死亡率院内低血糖的危害
死亡率
0.18
0.160.14
0.120.10
0.08
0.06
0.040.02
0.00
3030-3939
(49)(76)(213)
住院期间最低血糖每降低10mg/dl,住院患者死亡
风险增加3倍
住院期间最低血糖(mg/dl)
目录CONTENT
①低血糖的概述及其临床表现
②低血糖的危害
③低