术后危重病人强化胰岛素治疗的实施  

Intensive Insulin Therapy in Postoperative Intensive Care Unit Patients

作　　者：阿伟[1] 张彤彦[1] 许媛[1] 周华[1] 李彤[1] 侯静[1] 赵京阳[1] 赵栋[1] 柳絮海[1] 

机构地区：[1]首都医科大学附属北京同仁医院SICU,北京100730

出　　处：《麻醉与监护论坛》2006年第5期258-259,共2页Forum of Anesthesia and Monitoring

摘　　要：应激性高血糖是ICU病人常见的临床现象，与危重病严重程度相关，并成为一独立因素影响病人的预后。因此，严格控制血糖水平已成为危重症综合治疗中的一项重要策略。目的：建立一个便于掌握的血糖控制草案，使危重病人的血糖得到安全，有效的控制。方法：145例术后入ICU时间24小时以上，年龄〉16岁的危重病人，分为草案前组（n=44,每位医生根据自身经验调节胰岛素泵入速度）和草案组（n=101,使用我科制定的强化胰岛素治疗方案调节胰岛素泵入速度），控制血糖目标80-110mg/dl.结果：两组在平均血糖，平均清晨血糖，高血糖指数有显著性差异（P〈0.001）;草案组四间位间距虽有减少但无统计学差异，低血糖（〈60mg/dl和61＇70mg/dl）发生率无统计学差异。结论：通过本程序化管理的强化胰岛素治疗草案有助于严格血糖控制策略的安全，有效实施，并易于掌握，推广。Objective：To set up an easy control graft solution to control the blood glucose level safely and efficiently.Methods：145 critical patients,elder than 16 years and stayed in ICU more than 24hours after operation,were participated in the study and divided into presolution group（n=44 Insulin federate is base on physician individual experience.）and draft-solution group （n=101 Insulin federate is base on intensive insulin treatment solution applied in our department）,The blood glucose level was maintained between 80-110mg/dl.Resuits：Significantly difference between the two groups on average blood glucose,average moming blood glucose and hyperglycemic index（P〈0.01）There were no statistic differences in the inter quartile range and incidence of hypoglycemia（〈60mg/dl and 61-70mg/dl）,Conclusion ：The programmed intensive insulin treatment graft solution is helpful to execute the strategy of strictiy control glycemia and easily can be understood and used extensively.

关 键 词：血糖 危重症 胰岛素 低血糖 

分 类 号：R587.105[医药卫生—内分泌]