糖尿病患者围手术期使用胰岛素泵的临床研究  

Clinical study on the continuous insulin subcutaneous infusion of diabetics in the perioprative period

作　　者：何兰杰[1] 崔岩[1] 刘萍[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2005年第10期670-672,共3页Ningxia Medical Journal

摘　　要：目的研究糖尿病患者围手术期持续皮下注射胰岛素(胰岛素泵)的可行性及血糖稳定对患者围手术期危险性的影响。方法在就诊于我院外科患者中随机选取97例糖尿病患者使用胰岛素泵和132例常规皮下胰岛素注射治疗,在开始使用胰岛素泵和胰岛素常规皮下注射治疗时,根据不同的情况确定围手术期糖尿病患者的基础量和餐前大剂量以及三餐前注射剂量,使血糖于术前、术中、术后均维持在围手术期理想的血糖范围。结果在使用持续皮下胰岛素注射治疗之后,患者的血糖在术前、术中、术后较使用前明显的降低,对照组患者血糖亦明显下降。但两组血糖控制所需时间存在显著性差异(P<0.05),持续皮下输注胰岛素治疗组中有1例出现切口愈合不良;对照组为19例。结论持续皮下输注胰岛素的方式模拟胰岛素分泌,从而将围手术期血糖在短期内控制到满意水平,可以降低缩短住院日,减少手术并发症。Objective To study the feasibility of continuous insulin subcutaneous infusion and the effect of blood sugar stability to the prognosis （fatalness） of diabetic patients in the perioperative period. Methods Cases 97 patients who used continuous insulin subcutancous infusion bump and 132 patients who were insulin subcutaneous iniection. All the patients were randcraized selected from our hospital surgical admission patients with type 2 diabetes mellitus. At the therapy beginning, according to the different situations about patients decided the basic dosage, preprandial bolus dosage when the patients used insulin pump and three preprandial dosage when the patients were choice for insulin subcutaneous injection to keep the blood glucose in a suitable （an idea） level range wiaatever pre-, intra - and postoperative period. Results in any situation, the blood sugar level of the patients who apply continuous insulin subcutaneous infusion reduce obviously compared with their previous states, and so did the control group. However, the time to control the blood sugar Level was significant different between the two groups （ P 〈 0.05）. There was only one case which showed bad wound healing of operative incision in the group of continuous insulin subcutaneous infusion pump, but there were 19 cases in the control group. Conclusion The method of continuous insulin subcutaneous infusion can imitate tbe “physiolegical insulin secretion”, so that the blood sugar in the perioperative period can be adjusted to the satisfying level in a short time, and the time of hospitalization and the operative complication could be reduced.

关 键 词：糖尿病 围手术期 皮下注射 胰岛素 

分 类 号：R619[医药卫生—外科学] R587.1[医药卫生—临床医学]