胰岛素强化治疗心内直视术后应激性高血糖的疗效  

Effect of Intensive Insulin Therapy on Stress Hyperglycemia after Openheart Surgery

作　　者：刘喜利[1] 唐白云[2] 陈光献[2] 熊迈[2] 张希[2] 

机构地区：[1]广东化工制药职业技术学院,广东广州510520 [2]中山大学附属第一医院心脏外科,广东广州510080

出　　处：《现代食品与药品杂志》2007年第3期53-57,共5页JOurnal of Modern Food and Pharmaceuticals

摘　　要：目的探讨心内直视术后应激性高血糖胰岛素强化治疗的疗效及对预后的影响。方法将63例术后高血糖患者随机分为胰岛素强化治疗组(33例)和常规胰岛素治疗组(30例),强化治疗组对于术后血糖超过8 mmol/L即行胰岛素治疗,剂量从0.1 U/kg·h开始,根据血糖结果调整胰岛素用量,目标治疗为术后血糖控制在6～8 mmol/L水平;常规治疗组术后血糖超过11.1 mmol/L才给予胰岛素治疗,目标治疗为术后血糖控制在10～11.1 mmol/L水平。两组均同时监测生命体征、感染、心律失常、低血糖等并发症情况,并进行统计分析。结果胰岛素强化治疗组感染率、心律失常发生率均明显低于胰岛素常规治疗组(P<0.05)。结论提示术后应激性高血糖是影响患者预后的独立因素,在积极减少应激综合治疗的同时进行胰岛素强化治疗并将血糖控制在6～8 mmol/L水平可以减少术后并发症,改善疾病的预后。Objective To observe the effect of intensive insuhn therapy on stress hyperglycemia after open-heart surgery. Methods 63 hypoglycemia patients after surgery were randomly divided into 2 groups： intensive insulin therapy group（ 33 cases） and normal insulin therapy group（30 cases）. In the intensive group,patients with blood glucose over 8 mmol/L were treated by insulin, and dosage started from 0.1 U/kg · h, which was adjusted according to the result of blood glucose, the blood glucose should be controlled under 6 ～ 8 mmol/L after surgery. In the normal group ,the patients with blood glucose over 11.1 mmol/L were treated insulin, the blood glucose should be controlled under 10 ～ 11.1 mmol/L. The life sign, infection, arrhythmia, hypoglycemia were inspected in two groups. Results The infection rate and arrtythmia rate in intensive group were obviously lower than in normal group （ P 〈 0.05 ）. Conclusions Stress hyperglycemia is an independent element for affecting patient outcome. Positive-decreasing stress and intensive insulin therapy must be carried out at the same time, and blood glucose can be controlled under 6 ～ 8 mmol/L, so as to decrease complications after surgery and improve the outcome. 　

关 键 词：胰岛素强化治疗 心内直视术 应激性高血糖 疗效 

分 类 号：R977.15[医药卫生—药品]