外科重症病人应激性高血糖的控制与争议

被引：16

作者：

石岩

刘大为

机构：

[1] 中国医学科学院北京协和医学院北京协和医院ICU

来源：

中国实用外科杂志 | 2010年 / 30卷 / 11期

关键词：

外科重症病人; 应激性高血糖; 强化胰岛素治疗;

D O I：

暂无

中图分类号：

R605 [外科治疗学];

学科分类号：

100210 [外科学];

摘要：

外科重症病人普遍存在应激性高血糖,其预示或导致不良预后。近年研究显示强化胰岛素治疗(intensive insulin therapy,IIT)的益处,医疗机构纷纷效仿,但新的问题随之产生,如IIT显著增加低血糖的发生率,难以复制前期的优势结果等。人们开始对IIT产生怀疑,该如何面对关于控制血糖的各种争议?首先,争议是一种进步,不必因此而彻底否定高血糖对机体的损害,忽视或者彻底摒弃血糖控制。再者,现阶段应掌握血糖控制的"度"。实际工作中了解血糖控制并不仅是应用胰岛素控制血糖,必须注意其他影响血糖的因素,制定完备的方案。同时鉴于目前IIT还有许多悬而未决的问题,需要设计更为严谨的研究加以阐述。

引用

收藏

页码：926 / 930

页数：5

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