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目的探讨品管圈活动对胰岛素强化治疗脓毒血症所致低血糖症的预防效果。方法选取我院2014年1月至2015年1月收治的98例行胰岛素强化的脓毒血症患者为研究对象,根据品管圈活动开展时间(2014年7月至2015年1月)分成研究组和对照组各49例。对照组患者为品管圈活动开展前入组者,予以常规护理措施;研究组患者为品管圈活动开展后入组者,予以品管圈活动干预措施。对比两组患者血糖达标时间、胰岛素使用总量、ICU入住时间、总住院时间等干预指标差异,记录其低血糖症发生率及28d生存率差异。结果研究组患者血糖达标时间、ICU入住时间、总住院时间及胰岛素使用总量均显著低于对照组患者,差异具有统计学意义(P<0.05)。研究组患者低血糖症发生率为10.2%,显著低于对照组的28.6%,差异具有统计学意义(P<0.05)。对照组患者28d生存率为49.0%,显著低于研究组患者的69.4%,差异具有统计学意义(P<0.05)。结论对行胰岛素强化治疗的脓毒血症患者予以品管圈活动干预措施,可有效降低低血糖症发生风险,对缩短血糖达标时间、减少胰岛素使用量等具有积极影响,值得临床推广。
Objective To investigate the preventive effect of QA activities on hypoglycemia induced by intensive insulin treatment of sepsis. Methods A total of 98 patients with insulin-refractory sepsis admitted in our hospital from January 2014 to January 2015 were selected and divided into studies according to the quality control cycle (July 2014 to January 2015) Group and control group of 49 cases. Patients in the control group were pre-enrollment for quality control circle activities, and routine nursing measures were given. Patients in study group were re-enrolled in QC circle activities and were given quality control circle activities intervention measures. Comparing the two groups of patients blood glucose compliance time, the total amount of insulin, ICU admission time, total length of hospital stay and other indicators of intervention, record the incidence of hypoglycemia and 28d survival rate differences. Results The blood glucose level, ICU admission time, total length of hospital stay and total insulin use in the study group were significantly lower than those in the control group. The difference was statistically significant (P <0.05). The incidence of hypoglycemia in the study group was 10.2%, which was significantly lower than that in the control group (28.6%), the difference was statistically significant (P <0.05). The 28-day survival rate was 49.0% in the control group, which was significantly lower than 69.4% in the study group (P <0.05). Conclusion Intervention measures of quality control circle in patients with sepsis treated with insulin-intensive therapy can effectively reduce the risk of hypoglycemia, have a positive effect on shortening blood glucose compliance time and reduce the amount of insulin used, which is worthy of clinical promotion.