胰岛素泵在糖尿病酮症治疗中的应用  

Clinical application of insulin pump in treatment of diabetic ketoaciduria

作　　者：杨建明[1] 邹秀兰[1] 余萍[1] 

机构地区：[1]湖北省宜昌市第一人民医院内分泌科,443000

出　　处：《中国医师进修杂志》2006年第3期13-15,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价胰岛素泵连续皮下输注(CSII)和静脉连续胰岛素输注(CVII)在糖尿病酮症治疗中的疗效差异。方法120例糖尿病酮症患者分为两组,CSII组和CVII各60例,观察两组不同方法的治疗效果。结果两组治疗后血糖明显下降,尿酮体均能恢复正常,CSII组优于CVII组,差异有统计学意义(P<0 05);CSII组平均胰岛素用量为(42.5±6.3)U/d明显少于CVII组(57.8±6.6)U/d(P<0 05);CSII组尿酮体恢复正常所需时间为(18.5±5.9)h明显短于CVII组(39.8±8.4)h(P<0 01);CSII组低血糖发生率为(0.41±0.13)次/例,显著低于CVII组的(0.96±0.45)次/例(P<0 05)。两组均无死亡病例。结论CSII模拟胰岛素的生理分泌模式,能更快、更有效地纠正代谢紊乱,控制高血糖,提高生活质量。Objective To evaluate the difference of efficacy between continuous subcutaneous insulin infusion（CSII）and continuous intravenous insulin infusion（CVII）with human insulin in patients with diabetic ketoaciduria or ketoacidosis（DKA）. Methods 120 patients with DKA were randomized into two groups,one was CSII group by a portable insulin pump（60 cases）, the other was CVII group（60 cases）. Results Both of CSII and CVII were effective in controlling blood glucose levels. CSII therapy provided better glycemic control（P〈0.01）. Mean insulin doses were significantly lower with CSII than with CVII [ （42.5 ± 6.3 ） U/d vs （ 57.8 ± 6.6） U/d, P 〈 0.05 ] ; the time to normal ketonuria was ：shorter in CSI I group than that in CVII group, （ 18.5 ± 5.9）h vs（39.8 ± 8.4 ）h, （ P 〈 0.01 ）. The rate of hypoglycemia in CSII group was lower than that in CVII group（0.41 ± 0.13）vs（0. 96 ± 0.45） （ P 〈 0.05） ;there was no dead case in CSII and CVII. Conclusions CSII can simulate pattern of insulin secretion and it is more effective in treating katoaciduria and hyperglycemia . It can rapidly correct metabolic disorder and improve the quality of life.

关 键 词：糖尿病酮症酸中毒 胰岛素泵 连续皮下注射 

分 类 号：R587.2[医药卫生—内分泌] R587.1[医药卫生—内科学]