Page 114 - 《中国药房》2022年17期

临床药师参与的多学科协作全院血糖管理模式介绍与效果评价 Δ

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计 成 1，2＊ ，代 晶 ，李林通 ，李佳希 ，葛卫红 （1.南京大学医学院附属鼓楼医院药学部，南京 210008；2.南
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京大学医学院附属鼓楼医院内分泌科，南京 210008；3.苏州大学附属第二医院药学部，江苏 苏州 215004；
4.中国药科大学基础医学与临床药学学院，南京 210009）

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2022）17-2152-05
DOI 10.6039/j.issn.1001-0408.2022.17.21

摘 要 目的 介绍临床药师参与的多学科协作全院血糖管理（以下简称“全院血糖管理”）模式，评价其在围手术期糖尿病患者血
糖管理中的应用效果。方法 介绍南京大学医学院附属鼓楼医院全院血糖管理模式的流程、临床药师工作内容。纳入择期手术的
2型糖尿病患者300例，随机分为普通会诊组（对照组）和全院血糖管理组（干预组），比较两组患者血糖管理效果和术前等待时间、
住院天数等指标。结果 全院血糖管理团队以内分泌科全院血糖管理医师、临床药师、护士为核心成员，主要服务流程分为初次管
理、日常管理、出院管理和随访。临床药师作为团队秘书，主要负责每天汇总管理患者的血糖水平及特殊状况，定期进行管理效果
评价，开展药学查房、医嘱审核、药学监护，及时对患者血糖进行评估以及指导患者合理用药等工作。与干预前比较，干预3 d后，
两组患者的空腹血糖、餐后血糖水平均显著降低（P＜0.05），且干预组显著低于对照组（P＜0.05）；与对照组比较，干预组患者的血
糖波动幅度显著减小（P＜0.05），其血糖水平标准差已达到目标控制水平，餐后血糖波动幅度、最大血糖波动幅度接近目标控制水
平；术前血糖达标率、出院时血糖达标率均显著升高（P＜0.05）；术前等待时间和住院天数均显著缩短（P＜0.05）。结论 临床药师
参与的多学科协作全院血糖管理模式，可以更加平稳、有效地控制围手术期糖尿病患者的血糖水平，对改善患者的疾病治疗及预
后有着现实意义。
关键词 全院血糖管理；多学科协作；药学服务；临床药师

Introduction and evaluation of multidisciplinary collaborative blood glucose management mode of the
whole hospital with the participation of clinical pharmacists
JI Cheng ，DAI Jing ，LI Lintong ，LI Jiaxi ，GE Weihong（1. Dept. of Pharmacy，Drum Tower Hospital
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Affiliated to Medical School of Nanjing University，Nanjing 210008，China；2. Dept. of Endocrinology，Drum
Tower Hospital Affiliated to Medical School of Nanjing University，Nanjing 210008，China；3. Dept. of
Pharmacy，the Second Affiliated Hospital of Soochow University，Jiangsu Suzhou 215004，China；4. College of
Basic Medicine and Clinical Pharmacy，China Pharmaceutical University，Nanjing 210009，China）
ABSTRACT OBJECTIVE To introduce multidisciplinary collaborative blood glucose management mode（hereinafter referred as
to blood glucose management mode of the whole hospital）of the whole hospital with the participation of clinical pharmacists，and
to evaluation it effects on the blood glucose management of perioperative diabetes patients. METHODS The process of blood
glucose management mode of the whole hospital in Drum Tower Hospital Affiliated to Medical School of Nanjing University and
the work content of clinical pharmacists were introduced. Three hundred patients with type 2 diabetes mellitus who underwent
elective surgery were included and randomly divided into general consultation group （control group） and hospital-wide glucose
management group（intervention group）. The effect of glucose management and indicators such as preoperative waiting time and
total length of stay were compared between 2 groups. RESULTS In the blood glucose management team of the whole hospital，the
physicians，clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members，and
the management process was divided into initial management，daily management，discharge management and follow-up. As the
team secretary，the clinical pharmacists were mainly responsible for daily summarizing and managing the blood glucose level and
special conditions of patients，regularly evaluating the management effect，carrying out pharmaceutical ward rounds，medical order
review， pharmaceutical care， timely assessing the blood
Δ 项目基金 江苏省医学重点学科项目（No.ZDXKB2016012）；广
glucose of patients and guiding the rational use of drugs.
东省药学会研究基金项目（No.2020ZX03）；南京临床医学中心建设项
Compared with before intervention， after 3 days of
目（No.宁卫科教〔2020〕1 号）；南京鼓楼医院临床研究专项资金项目
intervention，the levels of fasting plasma glucose（FPG）and
（No.2021-LCYJ-PY-33）
postprandial blood glucose （PBG） were decreased
＊第一作者 副主任药师，硕士。研究方向：慢病管理与药学服
务。电话：025-83106666-40130。E-mail：getcct@sina.com significantly in 2 groups （P＜0.05）；intervention group was
# 通信作者 主任药师，硕士。研究方向：临床药学。电话：025- significantly lower than control group （P＜0.05）. Compared
83106666-66660。E-mail：6221230@sina.com with control group， the fluctuation of blood glucose in

·2152 · China Pharmacy 2022 Vol. 33 No. 17 中国药房 2022年第33卷第17期