关键词: 高血糖症, 网络血糖监测系统, 院内血糖管理, 住院时间, 住院费用, 影响因素分析

Abstract: Background　Due to the lacking of the relative knowledge of blood glucose management by surgeons，the blood glucose control of hyperglycemic patients in surgical departments is often not ideal.However，the traditional blood glucose management consultation mode has the disadvantages of low efficiency and difficulty in follow-up.Objective　In order to make the inpatient blood glucose management more efficient，the impact of the mode of inpatient blood glucose management team combined with network-based glucose minitoring system（NBGMS）on the blood glucose control of patients with hyperglycemia in the surgical department was explored in this study，as well as the impact on the length and the cost of hospitalization.Methods　Patients with hyperglycemia in non-critical surgery departments admitted from 2018-01-01 to 2018-06-30 were selected and intervened actively in the mode of inpatient blood glucose management team combined with NBGMS（team management group）.Patients with hyperglycemia in non-critical surgery departments admitted from 2017-01-01 to 2017-06-30 were selected and managed in the regular consultation mode（conventional consultation group）.The blood glucose control level of the two management modes was compared，and the multiple regression model was used to analyze the influencing factors of the hospitalization time and expenses of patients with hyperglycemia.Results　Compared with routine consultation group：（1）the test rate of glycosylated hemoglobin，the average number of blood glucose tests per person per day，the proportion of patients who used basal insulin during hospitalization，and the proportion of patients who received intravenous insulin during hospitalization in team management group were all significantly higher（P<0.05）；（2）the average blood glucose level，the incidence of hyperglycemia，and the incidence of severe hyperglycemia of the team management group were significantly lower and the target blood glucose compliance rate was significantly higher（P<0.01）；（3）the blood glucose drift，blood glucose variation coefficient and maximum blood glucose fluctuation range of the team management group were significantly lower（P<0.01）；（4）the incidence of nosocomial infection and hospitalization expenses were significantly lower（P<0.05）.Multiple linear regression analysis showed that the influencing factors of hospitalization length included blood glucose drift（B=0.506，t=5.360，P<0.01）and whether there was nosocomial infection（B=10.694，t=32.281，P<0.01）；the influencing factors included the maximum blood glucose fluctuation range（B=0.008，t=2.731，P=0.006）and the length of hospitalization（B=0.112，t=37.501，P<0.01）.Conclusion　The mode of inpatient blood glucose management team combined with NBGMS could improve the hyperglycemia and glucose variability of patients in surgical departments effectively，and then shorten the length of stay and reduce the medical costs.

Key words: Hyperglycemia, Network-based glucose monitoring system, Inpatient blood glucose management, Length of stay, Hospitalization expenses, Root cause analysis