脓毒症患者临床需接受大剂量维生素C治疗进行抗氧化、免疫调节以及改善血管内皮功能。本文报告1例脓毒症患者经大剂量维生素C治疗影响静脉血糖检验结果的诊治经历及期间护理评判性思维路径。虽然患者最后的结局很差,但总结的护理管理经验能提高护士对于急危重症患者的评判性思维能力,发挥护理质量的前馈控制,使护理质量的提高变得积极而有效。
In clinical practice, high-dose vitamin C is used for septic patients to play roles in antioxidant, immunomodulation, and improvement of vascular endothelial function. This article reported a septic patient treated with high-dose vitamin C, which affected the test results of venous blood glucose, and summarized nursing critical thinking. Although the patient ended up with a poor outcome, summarizing nursing management experience would improve the nursing critical thinking for severe patients, and play a feedforward control, so as to positively and effectively improve nursing quality.
[1] 王海军,邢学忠,曲世宁,等.肿瘤合并脓毒症患者的近期和中期预后影响因素分析[J].中国医刊,2021,56(6):613-616.
[2] van der Poll T, Shankar-Hari M, Wiersinga WJ. The immunology of sepsis[J]. Immunity, 2021, 54(11): 2450-2464.
[3] 赵翰卿,李欣怡,汪瑞琦,等.维生素家族对免疫细胞影响的研究进展[J].生命科学,2020,32(4):343-348.
[4] 黄小聪,许丽宣,赖冬梅.四联方案联合维生素C对2型糖尿病合并胃溃疡患者血糖水平的影响[J].糖尿病新世界,2024,27(14):105-108.
[5] 赵丽. 血糖测定方法的进展(综述)[J].安徽卫生职业技术学院学报,2016,15(1):141-143.
[6] Ten Berge D, Muller W, Beishuizen A, et al.Significant interference on specific point-of-care glucose measurements due to high dose of intravenous vitamin C therapy in critically ill patients[J]. Clin Chem Lab Med, 2020, 59(5): e197-e199.
[7] Zhang Y, Huang W.Never a rose without a prick: pseudohyperglycemia when administering high-dose intravenous vitamin C[J]. Crit Care, 2020, 24(1): 251.
[8] 中华医学会糖尿病学分会. 中国糖尿病防治指南(2024版)[J]. 中华糖尿病杂志,2025,17(1):16-139.
[9] 幸延斌. 血糖检测仪的发展、临床应用与选购[J].中国医疗器械信息,2008,14(12):25-29.
[10] 中国医学装备协会检验医学分会,中华医学会检验医学分会.即时检测(POCT)临床结果报告与发布中国专家共识[J]. 中华检验医学杂志,2020,43(5):567-569.
