关键词: 脓毒症, 危重病, 应激高血糖, 血糖监测, 高胰岛素血症, 低血糖血症

Abstract:

Blood glucose control in surgical sepsis        ZHAO Yun-zhao，TIAN Tao. Research Institute of General Surgery，Jinling Hospital，Nanjing University School of Medicine，Nanjing 210002，China
Corresponding author：ZHAO Yun-zhao，E-mail：yz_zhaomd@163.com
Abstract    Compensation responses such as hypermetabolism and stress hyperglycemia can be come out in stressed condition. It can help body overcome stress-associated damage，supply energy for organs，and protect organ functions. However，excessive stress responses may injury body and bring out several metabolic disorders. Then，metabolites will accumulate in the body，which can badly damage body. The body will appear various disturbances such as water and electrolyte and acid-base disorder, increased incidence of infection，exacerbated ischemia of heart and brain，and enhanced inflammatory responses. Therefore，blood glucose control can help patients improve stress reactions，ameliorate complications，and decrease critical illness mortality. However，the protocol for blood glucose levels with intensive insulin therapy remains controversy. Intensive insulin therapy may also result in hypoglycemia. Timely and accurate blood glucose monitoring is the foundation of blood glucose control. Primary diseases treatment and insulin therapy are key procedures for glucose control. Meanwhile，it is crucial to decrease the variability in glucose levels over time.

Key words: sepsis, critical illness, stress hyperglycemia, blood glucose monitoring, hyperinsulinemia, hypoglycemia