护理学报2025，Vol.32Issue(19)：30-35,6.DOI:10.16460/j.issn2097-6569.2025.19.030
原发性肝癌切除手术中目标导向性血糖监测的循证实践
Evidence-based goal-directed glycemic monitoring during resection for primary liver cancer
摘要
Abstract
Objective To provide basis for standardizing intraoperative glycemic control by applying the evidence for goal-directed glycemic monitoring during resection for primary liver cancer established in prior research.Methods An evidence-based practice protocol was developed based on clinical context and best available evidence,and was subsequently implemented in the operating de-partment of a tertiary grade-A general hospital.A comparative analysis was conducted before and after its implementation to evaluate the following outcomes:(1)intraoperative glycemic monitoring results,glycemic control efficacy,and hepatocellular injury in patients with primary hepatocellular carcinoma;and(2)the compliance rate with nurse audit indicators and awareness level regarding the evi-dence.Results The intraoperative 2-hour blood glucose monitoring results of the two groups of patients were 5.70±1.34 and 7.09±2.47,respectively,with a statistical significance(P=0.001).There was no statistical significance in blood glucose values of other monitoring points during the operation(P>0.05).After evidence implementation,the incidence of intraoperative hyperglycemia,the standardization rate of glycemic monitoring,and the timely treatment rate of abnormal blood glucose were 11.53%,100%,and 53.84%,respectively,showing statistical significance when compared with those in the baseline audit group(28.84%,23.07%,and 0.00%)(P<0.05).No statis-tically significant difference was observed in the hepatocellular injury monitoring outcome indicators(P>0.05).Following the implemen-tation of the evidence-based protocol,nurses'compliance with audit indicators 1-14 reached 100%,with indicators 1,4,5,6,8,and 14 showing statistically significant improvements(P<0.01).The evidence-based practice group achieved a significantly higher theoreti-cal test score(92.60±6.28)compared to the baseline audit group(79.50±5.32),with a statistically significant difference(P<0.001).Conclusion The implementation of evidence-based goal-directed glycemic monitoring during resection for primary liver cancer has established standardized guidelines for intraoperative glycemic monitoring,effectively increasing the timely intervention rate for abnor-mal glucose levels and improving intraoperative glycemic control,thereby better ensuring patient safety during surgery.关键词
肝癌手术/目标导向性/血糖监测/高血糖/低血糖/循证实践Key words
liver cancer surgery/target-oriented/blood glucose monitoring/hyperglycemia/hypoglycemia/evidence-based practice分类
临床医学引用本文复制引用
周毅峰,杨继平,胡正中,袁浩..原发性肝癌切除手术中目标导向性血糖监测的循证实践[J].护理学报,2025,32(19):30-35,6.基金项目
2023年湖南省教育厅科研基金课题(23C0024) （23C0024）
2023年湖南省自然科学基金课题(2023JJ60315,2024JJ9234) （2023JJ60315,2024JJ9234）
2023年湖南省护理学会科研基金课题(HNKY202305) （HNKY202305）
2024年度软科学研究计划项目(kh 2502036) （kh 2502036）
