关键词: 外科重症病人, 应激性高血糖, 强化胰岛素治疗

Abstract:

Glycemic control and controversy in surgical critically ill patients with stress hyperglycemia        SHI Yan，LIU Da-wei. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730,China
Corresponding  author ：LIU Da-wei, E-mail：dwliu@medmail.com.cn
Abstract    Stress hyperglycemia develops commonly in surgical critically ill patients and it may indicate or even cause poor prognosis. Benefits of intensive insulin therapy (IIT) were demonstrated by many recent studies. As IIT is administered by more and more institutions. Questions and controversies have been raised in terms of the safety and efficacy of the therapy. The tight glycemic control is still important especially in surgical intensive care, though some of the reports showed negative results. The intensity of glycemic control should be optimal. It's essential to understand that insulin therapy is not the only way to maintain normoglycemia and other factors which are involved in glucose metabolism should also be noticed in glycemic control plans. More concise studies are still need to provide further guide for the best practice of the implementation of ITT.

Key words: surgical critically ill patients, stress hyperglycemia, intensive insulin therapy