以质量求发展,以服务铸品牌

护理学报 ›› 2024, Vol. 31 ›› Issue (7): 46-50.doi: 10.16460/j.issn1008-9969.2024.07.046

• 循证护理 • 上一篇    下一篇

肝癌切除手术患者目标导向性血糖监测的证据总结

周毅峰a, 杨继平a, 胡正中a, 袁浩b   

  1. 湖南省人民医院(湖南师范大学附属第一医院) a.手术部; b.检验科,湖南 长沙 410005
  • 收稿日期:2023-11-16 出版日期:2024-04-10 发布日期:2024-05-08
  • 通讯作者: 杨继平(1990-),女,湖南娄底人,硕士,主管护师。E-mail:yjp0927@hunnu.edu.cn
  • 作者简介:周毅峰(1981-),女,湖南益阳人,本科学历,硕士研究生在读,副主任护师。
  • 基金资助:
    2023年湖南省自然科学基金课题(2023JJ60315,2023JJ60313)

Evidence summary for target-oriented blood glucose monitoring in patients undergoing hepatocellular carcinoma resection

ZHOU Yi-feng a, YANG Ji-ping a, HU Zheng-zhong a, YUAN Hao b   

  1. a.Operating Room; b. Dept. of Clinical Laboratory, Hunan Provincial Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
  • Received:2023-11-16 Online:2024-04-10 Published:2024-05-08

摘要: 目的 检索并总结肝癌切除手术患者目标导向性血糖监测相关证据,为临床提供指导依据。方法 应用PICO程式结构化临床问题,检索中国指南网,美国指南网,英国国家临床医学研究所指南库,国际指南图书馆,英格兰学院间指南网,UpToDate,BMJ,Cochrane Library,PubMed,Web of Science,EMbase,CINAHL,中国生物医学数据库,中国知网,万方医学数据库。采用相关评价工具对纳入的文献进行质量评价。结果 共纳入文献15篇,包括指南6篇,专家共识3篇,原始研究6篇,总结出18条审查指标,包括多学科团队构建、术前评估及健康教育、监测方法、术前/术中/术后目标导向性血糖监测措施、异常血糖处理、术后交接及管理等内容。结论 本研究总结了肝癌切除手术患者目标导向性血糖监测的最佳证据,为规范临床血糖监测及控制,降低血糖异常事件及并发症发生率,加速术后康复提供循证依据。

关键词: 肝癌手术, 目标导向, 血糖监测, 围术期, 循证护理

Abstract: Objective To search and summarize the evidence for target-oriented blood glucose monitoring in patients undergoing hepatocellular carcinoma resection, and to provide guidance for clinical practice. Methods We applied PICO framework to structure clinical questions, and searched literature in databases of Chinese guidelines, American guidelines, UK National Institute of Clinical Medicine guidelines, International Guidelines Library, England inter-college guidelines, UpToDate, BMJ, Cochrane Library, PubMed, Web of Science, EMbase, CINAHL, China Biomedical Database, China National Knowledge Network, Wanfang Medical Database. Related evaluation tools were used to evaluate the quality of the included literature. Results A total of 15 pieces of literature were collected, including 6 guidelines, 3 expert consensus and 6 similar experimental studies. Eighteen review indicators were summarized, including team building, preoperative evaluation and health education, preoperative/intraoperative/postoperative target-oriented blood glucose monitoring measures, abnormal blood glucose management, postoperative handover and management, etc. Conclusion This study summarizes the best evidence for target-oriented blood glucose monitoring in patients undergoing hepatocellular carcinoma resection, providing evidence-based evidence for reducing the incidence of abnormal blood glucose events and complications and accelerating postoperative rehabilitation.

Key words: hepatocellular carcinoma resection, target-oriented, blood glucose monitoring, perioperative, evidence-based nursing

中图分类号: 

  • R473.73
[1] Niu X, Liu Jg, Feng ZD, et al.Short-term efficacy of precise hepatectomy and traditional hepatectomy for primary liver cancer: a systematic review and Meta-analysis[J]. J Gastrointest Oncol, 2021, 12(6):3022-3032. DOI: 10.21037/jgo-21-735.
[2] Dougherty SM, Schommer J, Salinas JL, et al.Immediate preoperative hyperglycemia correlates with complications in non-cardiac surgical cases[J].J Clin Anesth,2021,74:110375. DOI: 10.1016/j.jclinane.2021.110375.
[3] Stras WA, Wasiak D, Lągiewska B, et al. Recurrence of hepatocellular carcinoma after liver transplantation: risk factors and predictive models[J]. Ann Transpl, 2022, 27:e934924. DOI: 10.12659/AOT.934924.
[4] Kim S, Park J, Kim H, et al.Intraoperative hyperglycemia may be associated with an increased risk of myocardial injury after non-cardiac surgery in diabetic patients[J]. J Clin Med, 2021, 10(22). DOI: 10.3390/jcm10225219.
[5] 吴永红, 朱艳萍, 周艳. 目标导向血糖监测方案在多发伤患者血糖调控中的应用研究[J]. 护士进修杂志, 2015, 30(23):2137-2140. DOI: 10.16821/j.cnki.hsjx.2015.23.008.
[6] 胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018:28-35.
[7] Dicenso A, Bayley L, Haynes RB.Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs,2009,12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[8] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: advancing guideline development, reporting and evaluation in health care[J]. J Clin Epidemiol, 2010, 63(12):1308-1311. DOI: 10.1016/j.jclinepi.2010.08.005.
[9] 张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具 AMSTAR 2 解读[J]. 中国循证心血管医学杂志, 2018, 10(1):14-18. DOI: 1674-4055(2018)01-0014-05.
[10] The Joanna Briggs Institute. JBI's critical appraisal tools assist in assessing the trustworthiness, relevance and results of published papers[EB/OL]. (2017-11-24) [2020-06-13]. https://jbi.global/critical-appraisal-tools.
[11] 王春青,胡雁. JBI 证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015,30(11):964-967. DOI: 1002-6975(2015)11-0964-04.
[12] Joint British Diabetes Societies Inpatient Care Group. Guideline for perioperative care for people with diabetes mellitus undergoing elective and emergency surgery.[EB/OL]. (2021-03-10). https://www.JBDS-IP.cn/guideline/show_article.
[13] Australian Diabetes Society.Peri-operative diabetes management guidelines[EB/OL]. [2020-08-29].https://www.docin.com/p-395149843.html.
[14] Wang J, Chen K, Chen Y, et al.Chinese clinical practice guideline for perioperative blood glucose management[J]. Diabetes Metab Res, 2021,37(7):e3439. DOI:10.1002/dmrr.3439.
[15] Bao YQ, Zhu DL.Clinical application guidelines for blood glucose monitoring in China (2022 edition)[J]. Diabetes-Metab Res, 2022, 38(8):e3581. DOI: 10.1002/dmrr.3581.
[16] Joliat GR, Kobayashi K, Hasegawa K, et al.Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations 2022[J]. World J Surg,2023,47(1):11-34.DOI:10.1007/s00268-022-06732-5.
[17] 中华医学会外科学分会, 中华医学会麻醉学分会. 中国加速康复外科临床实践指南(2021)(肝胆部分)[J]. 协和医学杂志, 2021, 12(5):632-640. DOI: 10.12290/xhyxzz.20210002.
[18] 陈莉明, 陈伟, 陈燕燕, 等. 成人围手术期血糖监测专家共识[J]. 中国糖尿病杂志,2021,29(2):81-85.DOI:10.3969/j.issn.1006-6187.2021.02.001.
[19] Vogt AP, Bally L.Perioperative glucose management: current status and future directions[J]. Best Prac Res Clin Anaesthesiol, 2020, 34(2):213-224. https://doi.org/10.1016/j.bpa.2020.04.015.
[20] Duggan E, Chen Y.Glycemic management in the operating room: screening, monitoring, oral hypoglycemics, and insulin therapy[J]. Curr Diabetes Rep, 2019, 19(11):134. DOI: 10.1007/s11892-019-1277-4.
[21] Blixt C, Larsson M, Isaksson B, et al.The effect of glucose control in liver surgery on glucose kinetics and insulin resistance[J]. Clin Nutr, 2021, 40(7):4526-4534. https://doi.org/10.1016/j.clnu.2021.05.017.
[22] Gen L, Dietz CJK, Freundlich RE, et al.The impact of an intraoperative clinical decision support tool to optimize perioperative glycemic management[J]. J Med Syst, 2020, 44(10):175. DOI: 10.1007/s10916-020-01643-1.
[23] 吕素珍, 黄旭芳, 毛剑婷, 等. 强化血糖管理在肝癌合并糖尿病患者射频消融围手术期的应用研究[J]. 介入放射学杂志, 2019, 28(6):582-585. DOI: 10.3969/j.issn.1008-794X.2019.06.018.
[24] Cammu G, Vermeiren K, Lecomte P, et al.Perioperative blood glucose management in patients undergoing tumor hepatectomy[J]. J Clin Anesth, 2009, 21(5):329-335. DOI: 10.1016/j.jclinane.2008.09.006.
[25] Mendez CE, Walker RJ, Dawson AZ, et al.Using a diabetes risk score to identify patients without diabetes at risk for new hyperglycemia in the hospital[J]. Endocr Pract, 2021, 27(8):807-812. DOI: 10.1016/j.eprac.2021.04.003.
[26] 丁佑铭, 张爱民, 姚峰, 等. ICGR15和OGTT预测肝癌患者肝脏储备功能的价值[J]. 中国普通外科杂志, 2001, 10(2):162-165.DOI:10.3969/j.issn.1005-6947.2001.02.020.
[1] 张静, 彭焕椽, 陈佳, 鲁永锦, 刘克玄, 侯晓敏. 成人体外循环心脏手术患者预防手术部位感染的最佳证据总结[J]. 护理学报, 2025, 32(4): 41-47.
[2] 马小兰, 徐维昉. 基于症状管理理论的冰水喷雾对胸腔镜下肺叶切除术口渴患者的应用效果[J]. 护理学报, 2025, 32(4): 70-73.
[3] 李若雨, 刘鑫, 林萍, 陈丹, 林桦. 出院患者用药安全管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 50-55.
[4] 杨小娟, 毛孝容, 王静, 江华, 李蓉, 樊宇, 文青, 李林章, 陈晓容. 成人重度烧伤患者早期肠内营养管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 56-61.
[5] 刘硕怡, 熊莉娟, 李凌, 王玉梅, 何嘉, 李鑫, 袁淑蕾, 郭雪琴, 王暘婧, 张慧娟. 老年住院患者衰弱预防及管理临床实践指南的质量评价及内容分析[J]. 护理学报, 2025, 32(2): 50-55.
[6] 闫亚铃, 乐美妮, 姚桃琴, 王雪莲, 姜建玲, 辛艺. 老年胃肠肿瘤患者围手术期衰弱管理方案的构建[J]. 护理学报, 2025, 32(2): 74-78.
[7] 陈洁, 孟庆童, 刘惊今, 吴艳妮. 基于指南的慢性心力衰竭患者运动康复科普手册研制[J]. 护理学报, 2024, 31(9): 36-41.
[8] 符路路, 解艺璇, 王玥, 魏巍, 张传英, 朱宇. 新生儿操作性疼痛听觉刺激干预的证据总结[J]. 护理学报, 2024, 31(9): 42-47.
[9] 纪锐婷, 林丹娜, 刘小成, 李婷婷, 谢映梅, 胡冰, 应文娟. 早产儿初乳口腔免疫疗法的最佳证据总结[J]. 护理学报, 2024, 31(8): 37-42.
[10] 张小莉, 杨鑫玉, 肖宇, 刘春燕, 张璐, 伍晓琴, 黄月霖, 傅静. 晚期癌症患者代理决策者安宁疗护决策后悔研究的范围综述[J]. 护理学报, 2024, 31(8): 49-54.
[11] 牛世莲, 袁丽, 李饶. 糖尿病患者动态血糖监测的结构化教育研究进展[J]. 护理学报, 2024, 31(6): 39-42.
[12] 莫选菊, 吴远, 张曼, 刘章来, 申铁梅. 共患慢性失眠症住院患者实施睡眠限制疗法的证据总结[J]. 护理学报, 2024, 31(6): 62-66.
[13] 杨建国, 何细飞, 鄢建军, 张梦, 杨纯子, 徐蓉, 王艳芳. 局部枸橼酸抗凝在连续性肾脏替代治疗中的应用及管理的最佳证据总结[J]. 护理学报, 2024, 31(4): 48-53.
[14] 刘璇, 蓝玉清, 李梦如, 王小惠, 钟雪梅, 周文. 住院老年性痴呆患者跌倒预防的最佳证据总结[J]. 护理学报, 2024, 31(4): 54-59.
[15] 祁水林, 林桦, 邓锐颖, 李荣杰, 李若雨, 王凤廷. 老年皮肤瘙痒症患者非药物管理的最佳证据总结[J]. 护理学报, 2024, 31(3): 46-50.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!