09年会——中青年优秀论文评奖国内外围手术期糖尿病管理临床指引.doc

09年会——中青年优秀论文评奖 国内外围手术期糖尿病管理临床指南比较分析 The Comparative Analysis of Domestic Perioperative Diabetes Management Guideline with Overseas Guidelines 作 者： 巫志国1，彭晓霞2，岳云1 作者单位： 1、首都医科大学附属北京朝阳医院麻醉科 2、首都医科大学公共卫生与家庭医学院流行病学与卫生统计学系 通讯作者： 岳云，首都医科大学附属北京朝阳医院麻醉科； 邮编：100020 Tel: +86-10 E-mail：yueyun@；wu.zhiguo@ 国内外围手术期糖尿病管理临床指南比较分析 中 文 摘 要 目的：对比分析国内外围术期糖尿病（DM）管理临床指南，规范DM患者的围术期血糖管理。 方法：使用Pubmed，CBMDisc数据库，Google等搜索引擎进行电子检索和人工检索，获取最新的糖尿病指南。检索截止时间为2009年4月1日。 结果：获得12篇来自不同国家和地区的糖尿病指南。依据入选标准和排除标准，选择其中8篇进行比较分析。 结论：美国糖尿病协会，国际糖尿病联盟，加拿大、中国和美国麻省糖尿病指南综合性较强，可提供纲领性的指导方针，但缺乏操作流程，可执行性欠佳。Joslin糖尿病中心，Rush大学和Yale糖尿病中心指南针对性更强，DM患者围术期管理建议详细，操作流程和管理策略对实际应用指导意义较强。中国的医疗机构，可参考以上指南，结合自身特点，制定出符合本院要求的围术期血糖管理规范。 关键词：糖尿病指南，围手术期，比较分析 The Comparative Analysis of Perioperative Diabetes Management Guidelines ABSTRACT Objective: To investigate the disparities of perioperative diabetes management strategies through a comparative analysis of domestic guideline with overseas’. Method: A combined electronic and manual search of Pubmed, CBMDisc database and Google were conducted to obtain the latest diabetes guideline until April 1st, 2009. Results: According to the inclusion and exclusion criteria, 8 guidelines out of 12 were selected for further analysis. Conclusion: On the whole, the guidelines of ADA (the American Diabetes Association), IDF (the International Diabetes Federation), Canada, China and Massachusetts are tend to be more comprehensive. They can be served as general practice guidance, but the lack of flow charts and insulin infusing protocols may make them hard to follow. However, the guidelines of Joslin, Rush and Yale have more details of perioperative management of diabetic patients, including the detailed flow charts and insulin infusing protocols. The latter guidelines may prove to be more useful in clinical practices. The health care providers may make full use of above mentioned guidelines combined with their own considerations to develop a perioperative management protocol for diabetic pati