Study On Standardization Of Perioperative Blood Glucose Management

ObjectiveTo standardize the treatment of perioperative blood glucose management,and to provide reliable guidance and basis for clinical medical staff.The aim is to improve the success rate of operation in patients with hyperglycemia,to save medical cost and to reduce the incidence of complications and mortality.MethodWe will adopt an onsite investigation method,i.e.we will investigate whether the medical staff in Department of Perioperative Blood Management in Northern China have the required knowledge about the perioperative blood glucose management.Through the HIS system database,we systematically collected the clinical data of surgical treatment of patients with diabetes,and description and statistical analysis in two surgical units,namely the Department of general surgery and Department of orthopedics,in the General Hospital of PLA from January 2010 to October 2015.According to the evidence-based medicinal method,we conducted in clinical investigation,and evaluated to the relevant domestic and international guidelines,followed by evidence collection,optimal treatment of perioperative blood glucose management by Delphi consensus.At the same time,the evaluation and classification of evidence were completed.ResultThe questionnaire survey to medical staff shows that all the endocrinologists and surgeons believed that perioperative blood glucose management was very important.However,the surgeons were lack of expertise and knowledge in diabetes.Now China has no guidelines in perioperative blood glucose management.Both endocrinologists and surgeons on perioperative blood glucose management related knowledge are insufficient.The perioperative blood glucose management in patients with surgical diabetes mellitus in the PLA General Hospital was not satisfactory from 2010 to 2015.The level of hyperglycemia in perioperative diabetic patients was related to the occurrence of postoperative complications.We conducted a standardized quality assessment of the existing perioperative guidelines.Important clinical problems were selected from three rounds of questionnaires surveys,and the problems were discussed according to the PICO(population,intervention,control and outcome)system.The first draft on the perioperative optimal treatment program was written,and the recommendation and procedure were reached after two rounds of Delphi and expert discussion.The GRADE classification was used to evaluate the classification of the evidence and to make recommendations.ConclusionThis study clarifies the level of blood glucose management knowledge of medical staff on perioperative through the current situation investigation.The current situation of surgical perioperative blood glucose management was also clarified from the retrospective study.The recommendations on perioperative blood glucose management was formed according to the evidence-based method.Therefore,it provides a scientific,accurate guidance for the clinical workers on the perioperative blood glucose management.It also clarified importance of the thorough cooperation among the medical staff,and the effective training of relevant personnel in perioperative blood glucose management.