严重脓毒症合并高血糖的强化胰岛素治疗  

Intensive Insulin Therapy in Severe Sepsis Complicated With Hyperglycemia

作　　者：崔金玲[1] 田卓民[1] 何慧英[1] 刘学花[1] 金涛[1] 李大祥[1] 

机构地区：[1]天津市人民医院,天津300121

出　　处：《内科急危重症杂志》2006年第5期230-232,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的：探讨强化胰岛素治疗方案对严重脓毒症患者预后的影响。方法：将102例严重脓毒症呼吸衰竭并高血糖患者随机分为强化胰岛素治疗组（将随机血糖控制在4．4～6．1mmol／L之间）和常规治疗组（当随机血糖超过12mmol／L开始应用胰岛素，将血糖控制在10～11．1mmol／L之间）。观察ICU病死率、住院病死率、ICU住院天数、总住院天数、呼吸机治疗时间和继发肝、肾功能异常情况。结果：与常规治疗组比较，强化胰岛素治疗组的ICU住院天数、总住院天数和呼吸机治疗时间均明显缩短（P〈0．01），继发性肾损害减：少（P〈0．05），ICU病死率和住院病死率虽然均有降低，但无统计学意义（P〉0．05）。结论：强化胰岛素治疗可以减少严重脓毒症并发高血糖患者的ICU住院时间和总住院时间，缩短呼吸机带机时间，降低继发性肾损害的发生率。Objective： To investigate the effect of intensive insulin therapy on severe sepsis complicated with hyperglycemia Methods： One hundred and two patients with severe sepsis with respiratory failure complicated with hyperglycemia were randomly divided into intensive insulin treatment group （random blood glucose maintained between 4. 4-6. 1 mmol/L） and routine treatment group （administered insulin when the random blood glucose level exceeded 12 mmol/L, with the blood glucose maintained between 10. 0-11.1 mmol/L）. The ICU mortality, hospital mortality, duration of ICU stay, total duration of hospitalization, time of needing mechanical ventilation, secondary abnormalities of the liver and kidney functions were observed. Results： The days of ICU stay, total duration of hospitalization and the time of mechanical ventilation application were shortened（P〈0. 01）, secondary renal damage was decreased （P〈0. 05） in intensive insulin treatment group compared with those in routine treatment group. ICU mortality and hospital mortality were decreased but with no statistic significance（P〉0. 05）. Conclusion： Intensive insulin therapy may decrease total duration of hospitalization, shorten the time of mechanical ventilation, decrease the incidence of secondary renal damage in patients with severe sepsis complicated with hyperglycemia.

关 键 词：脓毒症 胰岛素 血糖 

分 类 号：R587.1[医药卫生—内分泌]