Influence of Optimal Management of Hyperglycemia and Intensive Nursing on Blood Glucose Control Level and Complications in Patients with Postoperative Cerebral Hemorrhage

Abstract

Background. Cerebral hemorrhage, also known as hemorrhagic stroke, is a common clinical cerebrovascular disease, accounting for about 10%-30% of stroke, with high morbidity and mortality. Objective. To observe the effect of optimal management of hyperglycemia and intensive nursing on blood glucose control level and complications in patients with postoperative cerebral hemorrhage. Methods. One hundred and eight patients with postoperative cerebral hemorrhage comorbid with stress hyperglycemia admitted to our neurosurgery department from February 2019 to February 2022 were selected and divided into a general group of 54 cases and an optimized group of 54 cases by simple random method. The general group was managed with conventional care, while the optimized group developed optimized management of hyperglycemia for intensive care. The indexes related to blood glucose control, electrolytes, National Institutes of Health Stroke Scale (NIHSS) scores, Barthel Index (BI) scores, and time to achieve blood glucose standard, insulin pumping time, patient satisfaction, and prognosis were compared between the two groups. Results. Before intervention, there was no statistical significance in the comparison of blood glucose control-related indicators and electrolytes between the two groups ( P > 0.05 ). After 7 d and 14 d of intervention, the fasting blood glucose and 2 h postprandial blood glucose in the two groups were lower than before, while K+ and Na+ were higher than before ( P < 0.05 ). The blood glucose indexes at the same time point in the optimized group were found to be lower than those in the general group by statistical analysis, but electrolytes were not statistically significant when compared with the general group ( P > 0.05 ). In the optimized group, the time to achieve blood glucose standard ( 6.59 ± 1.94 ) d and insulin pumping time ( 7.14 ± 1.89 ) d were shorter than those in the general group [( 7.48 ± 2.12 ) d and ( 8.58 ± 2.14 ) d], insulin dosage ( 748.85 ± 63.61 ) U was less than that in the general group ( 923.54 ± 84.14 ) U, and the incidence of hypoglycemia (3.70%) was lower than that in the general group (16.67%), and the satisfaction rate (92.59%) was higher than that of the general group (77.78%), which was statistically significant ( P < 0.05 ). Before intervention, there was no significant difference in NIHSS score and BI score between the two groups ( P > 0.05 ). After 7 d and 14 d of intervention, the NIHSS scores of the two groups were lower than before, while the BI scores were higher than before, and the NIHSS scores of the optimized group at the same time point were all lower than those of the general group, and the BI scores were higher than those of the general group ( P < 0.05 ). The incidence of pulmonary infection (11.11%) and rebleeding (7.41%) in the optimized group were lower than those in the general group (25.93% and 22.22%), while deep vein thrombosis, multiple organ dysfunction syndrome (MODS), and death within 28 d was not statistically significant when compared with the general group ( P > 0.05 ). Conclusion. Optimal management of hyperglycemia and intensive nursing can effectively control the blood sugar level of patients after cerebral hemorrhage, reducing insulin dosage, and the occurrence of hypoglycemia, pulmonary infection, and rebleeding.

Machine learning predictors of risk of death within 7 days in patients with non-traumatic subarachnoid hemorrhage in the intensive care unit: A multicenter retrospective study

“…The hyperglycemic state affects brain tissue energy metabolism, leading to acidosis due to the accumulation of lactate, inducing oxidative stress, aggravating nerve cell injury, and worsening the prognosis in patients with intracerebral hemorrhage. Additionally, hyperglycemia levels have been linked to brain edema and neuronal apoptosis, and it has been reported to cause severe damage to the blood-brain barrier by lowering water channel proteins [ [49] , [50] , [51] ].…”

Nursing care of TURP and hyperglycemia integrating symptoms management model

“…15 Nursing care for managing hyperglycemia after surgery involves vigilant monitoring and a holistic approach to support patients living with diabetes in their postoperative recovery. 84 Nurses play a key role in frequent blood glucose monitoring, ensuring that levels remain within target ranges. They collaborate with healthcare providers to adjust insulin or other medications as needed to address any variations caused by the stress of surgery.…”

“…Continuous monitoring and regular assessments in the post‐operative phase help healthcare providers tailor the management of hyperglycemia to the individual patient's needs, ensuring a comprehensive approach to diabetes care during the recovery period 15 . Nursing care for managing hyperglycemia after surgery involves vigilant monitoring and a holistic approach to support patients living with diabetes in their post‐operative recovery 84 . Nurses play a key role in frequent blood glucose monitoring, ensuring that levels remain within target ranges.…”

Retracted: Influence of Optimal Management of Hyperglycemia and Intensive Nursing on Blood Glucose Control Level and Complications in Patients with Postoperative Cerebral Hemorrhage

“…This article has been retracted by Hindawi, as publisher, following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of systematic manipulation of the publication and peer-review process.…”