Kan örneği alınmasında kullanılan farklı yöntemlerin kan glukoz ölçümleri üzerine etkisi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma kan glukoz düzeyi ölçümünde venöz ve kapiller kan örnekleri
arasında farklılık olup olmadığının karşılaştırılması ve kan örneği alınmadan önce deri
temizliğinde kullanılan farklı yöntemlerin ölçüm sonuçlarına etkisinin incelenmesi
amacıyla eşit zaman (eşleştirilmiş) örneklemli yarı deneysel çalışma olarak
yapılmıştır.
Araştırma, 27 Kasım 2017- 30 Nisan 2018 tarihleri arasında Manisa Celal Bayar
Üniversitesi Hafsa Sultan Hastanesi kan alma birimine 75 gr OGTT için kan alma
birimine başvuran 109 hastada yürütülmüştür. Veriler araştırmacı tarafından sabah 8-
12 saatleri arasında toplanmıştır. Verilerin toplanmasında Birey Tanıtım Formu, Veri
Kayıt Formu ve glukometre cihazı kullanılmıştır.
Verilerin toplanmasında, 75 gr OGTT için açlık venöz kan alınan bireylerden
sırasıyla, kapiller kan glukozu ölçümü için eller yıkanmadan parmak %70’lik alkollü
pamukla silinip ilk ve ikinci kapiller kan damlası örneği, eller 30 sn yıkandıktan sonra
sağ orta parmaktan alınan ilk ve ikinci kapiller kan damlası örneği, elleri yıkandıktan
sonra sol orta parmak %70’lik alkollü pamukla silinip ilk ve ikinci kapiller kan damlası
glukoz ölçümü yapılmış ve kaydedilmiştir. Daha sonra, bireylere 75 gr şekerli içeceği
içirilmiş ve 2 saat sonra venöz kan glukoz ölçümü için kan örneği alınmış ve eller 30
sn yıkandıktan sonra sağ orta parmak alkolle silinip alınan ilk ve ikinci kapiller kan
glukoz ölçümleri yapılmıştır.
Verilerin analizinde, Friedman tekrarlı ölçümlerde varyans analizi, önemlilik
durumu ikili karşılaştırmalarda Bonferroni (Dunn) testi kullanılmış, Friedman varyans
analizi sonuçları median (min-max) olarak özetlenmiştir. İstatistik önemlilik düzeyi
p<0.05 olarak alınmıştır. Araştırmanın uygulanabilmesi için Manisa Celal Bayar
Üniversitesi Tıp Fakültesi Sağlık Bilimleri Etik Kurulun’dan, araştırmanın yapılacağı
Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hafsa Sultan Hastanesi’nden yazılı izin,
araştırma kapsamına alınan bireylerden bilgilendirilmiş onam alınmıştır.
Araştırma sonucunda; bireylerin yaş ortalamasının 45,56±12,32 yıl olduğu,
%61.5’inin kadın, %46,8’inin obez olduğu saptanmıştır. Farklı aseptik yöntemler
kullanılarak alınan açlık kapiller kan glukozu değerlerinin açlık venöz kan glukozu
değerinden yaklaşık %5 daha düşük bulunmuştur. Açlık kapiller kan glukozunun ilk kan damlası değerlerinin, ikinci kan damlası değerlerinden 1-3 mgr/dL daha düşük
olduğu saptanmıştır. OGTT’den 2 saat sonra ölçülen kapiller kan glukozu değerinin
venözden yaklaşık olarak %11 daha yüksek olduğu sonucuna ulaşılmıştır.
Araştırmada 75 gr şeker yüklemesi öncesi açlık venöz kan glukozu ortancasının,
eller sadece yıkanarak alınan, eller yıkandıktan sonra parmağın alkollü pamukla
silinerek alınan ve sadece parmağın alkollü pamukla silindikten sonra alınan kapiller
ilk kan damlası ortanca değerlerinden daha yüksek olduğu saptanmıştır (p<0,001).
Açlık venöz kan glukozu ortancasının, eller sadece yıkanarak alınan ve ellerin
yıkandıktan sonra parmağın alkollü pamukla silinerek alınan ikinci kan damlası
sonuçlarından daha yüksek olduğu (p<0,05), parmak alkolle silinerek alınan ikinci kan
damlası sonucu ile venöz kan değeri arasında farkın anlamlı olmadığı bulunmuştur
(p>0,05). OGTT’den 2 saat sonraki venöz kan glukozu değerinin, kapiller ilk kan ve
ikinci kan damlası değerlerinden daha düşük olduğu bulunmuştur (p<0,05).
OGTT’den 2 saat sonraki kapiller kan glukozu, ilk ve ikinci kan damlası değerleri
arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0,05).
Açlık kapiller kan glukozu ölçülürken eller yıkanmış ve alkolle silindikten sonra ilk
kan damlasının ölçüm için kulanılabileceği fakat kan glukozunun yüksek olduğu
değerlerde kapiller ikinci kan damlası değerinin kullanılması önerilmektedir.
This quasi-experimental study with matched samples was aimed at finding out whether venous and capillary blood samples affect blood glucose level measurements and investigating effects of different methods used in skin cleaning before taking a blood sample on the measurement results. The study was carried out in Hafsa Sultan Hospital of Manisa Celal Bayar University between November 27, 2017 and April 30, 2018. The study included 109 patients who presented to the blood collection unit for 75 g OGTT (Oral Glucose Tolerance Test). The study data were collected by the researcher between 8 a.m. and 12 noon. To collect the data, the Personal Information Form, Data Registration Form and a glucose meter were used. In the collection of the data, the procedure used to draw fasting venous blood for the 75 g OGTT was as follows: blood drop glucose measurements were made on the first and second capillary blood samples taken from the middle finger of the right hand cleaned with a 70% alcohol pad without washing the hands, on the first and second capillary blood samples taken from the middle finger of the right hand after washing the hands for 30 sec., on the first and second capillary blood samples taken from the middle finger of the left hand cleaned with a 70% alcohol pad after the hands are washed. Then the measurements were recorded. Then, the patients drank a solution that contained 75 grams of sugar and 2 hours later, blood samples were taken for venous blood glucose measurement. Finally, after the hands were washed for 30 seconds, blood drop glucose measurements of the first and second capillary blood samples taken from the middle finger of the right hand cleaned with a 70% alcohol pad were made. In the analysis of the study data, the Friedman test was used for repeated measures analysis of variance, Bonferroni (Dunn) test was used to perform pairwise comparisons, and Friedman analysis of variance results were summarized as median (min-max). P-values <0.05 were considered statistically significant. In order to carry out the study, the approval of the Manisa Celal Bayar University Faculty of Medicine Health Sciences Ethics Committee, written permission of the Hafsa Sultan Hospital of Manisa Celal Bayar University Faculty of Medicine and informed consent of the individuals included in the study were obtained. The mean age of the patients was 45,56 ± 12,32 years. Of them, 61,5% were female and 46.8% were obese. The fasting capillary blood glucose values obtained by using different aseptic methods were found to be 5% lower than the fasting venous blood glucose value. The first blood drop values of fasting capillary blood glucose were found to be 1-3 mg / dL lower than the second blood drop values. The capillary blood glucose value measured 2 hours after OGTT was approximately 11% higher than the venous blood glucose value. In the study, it was found that the fasting venous blood glucose median before the 75 g glucose load was higher than median values of the capillary first blood drop taken after the hands were washed, or after the fingers were cleaned with the alcohol pad after the hands were washed or after the fingers were cleaned with the alcohol pad (p <0,001). The fasting venous blood glucose median was found to be higher than the median value of the second blood drop (p <0,05) taken after the hands were washed, or after the fingers were cleaned with the alcohol pad after the hands were washed (p <0,05). The difference between the value of the second blood drop taken after the finger was cleaned with the alcohol pad and the venous blood value was not significant p> 0,05). It was found that venous blood glucose value measured 2 hours after OGTT was lower than the values of the first and second capillary blood drops (p <0,05). There was not a statistically significant difference between the first and second capillary blood glucose levels measured 2 hours after OGTT (p> 0,05). It is recommended that when fasting capillary blood glucose is measured, the first blood drop can be used for measurement after hands are washed and fingers are cleaned with alcohol pad, but that the second capillary blood drop should be used if blood glucose levels are high.
This quasi-experimental study with matched samples was aimed at finding out whether venous and capillary blood samples affect blood glucose level measurements and investigating effects of different methods used in skin cleaning before taking a blood sample on the measurement results. The study was carried out in Hafsa Sultan Hospital of Manisa Celal Bayar University between November 27, 2017 and April 30, 2018. The study included 109 patients who presented to the blood collection unit for 75 g OGTT (Oral Glucose Tolerance Test). The study data were collected by the researcher between 8 a.m. and 12 noon. To collect the data, the Personal Information Form, Data Registration Form and a glucose meter were used. In the collection of the data, the procedure used to draw fasting venous blood for the 75 g OGTT was as follows: blood drop glucose measurements were made on the first and second capillary blood samples taken from the middle finger of the right hand cleaned with a 70% alcohol pad without washing the hands, on the first and second capillary blood samples taken from the middle finger of the right hand after washing the hands for 30 sec., on the first and second capillary blood samples taken from the middle finger of the left hand cleaned with a 70% alcohol pad after the hands are washed. Then the measurements were recorded. Then, the patients drank a solution that contained 75 grams of sugar and 2 hours later, blood samples were taken for venous blood glucose measurement. Finally, after the hands were washed for 30 seconds, blood drop glucose measurements of the first and second capillary blood samples taken from the middle finger of the right hand cleaned with a 70% alcohol pad were made. In the analysis of the study data, the Friedman test was used for repeated measures analysis of variance, Bonferroni (Dunn) test was used to perform pairwise comparisons, and Friedman analysis of variance results were summarized as median (min-max). P-values <0.05 were considered statistically significant. In order to carry out the study, the approval of the Manisa Celal Bayar University Faculty of Medicine Health Sciences Ethics Committee, written permission of the Hafsa Sultan Hospital of Manisa Celal Bayar University Faculty of Medicine and informed consent of the individuals included in the study were obtained. The mean age of the patients was 45,56 ± 12,32 years. Of them, 61,5% were female and 46.8% were obese. The fasting capillary blood glucose values obtained by using different aseptic methods were found to be 5% lower than the fasting venous blood glucose value. The first blood drop values of fasting capillary blood glucose were found to be 1-3 mg / dL lower than the second blood drop values. The capillary blood glucose value measured 2 hours after OGTT was approximately 11% higher than the venous blood glucose value. In the study, it was found that the fasting venous blood glucose median before the 75 g glucose load was higher than median values of the capillary first blood drop taken after the hands were washed, or after the fingers were cleaned with the alcohol pad after the hands were washed or after the fingers were cleaned with the alcohol pad (p <0,001). The fasting venous blood glucose median was found to be higher than the median value of the second blood drop (p <0,05) taken after the hands were washed, or after the fingers were cleaned with the alcohol pad after the hands were washed (p <0,05). The difference between the value of the second blood drop taken after the finger was cleaned with the alcohol pad and the venous blood value was not significant p> 0,05). It was found that venous blood glucose value measured 2 hours after OGTT was lower than the values of the first and second capillary blood drops (p <0,05). There was not a statistically significant difference between the first and second capillary blood glucose levels measured 2 hours after OGTT (p> 0,05). It is recommended that when fasting capillary blood glucose is measured, the first blood drop can be used for measurement after hands are washed and fingers are cleaned with alcohol pad, but that the second capillary blood drop should be used if blood glucose levels are high.
Açıklama
Anahtar Kelimeler
Kan Glukoz Ölçümü, Venöz, Kapiller, Blood Glucose Measurement, Venous, Capillary
