胰岛素强化治疗在老年糖尿病患者并急性梗阻性化脓性胆管炎治疗中的应用  

Clinical effects of intensive insulin therapy on diabetes with acute obstructive suppurative cholangitis in elderly patients

作　　者：吴舟锋[1] 高山[1] 蒋天业[1] 

机构地区：[1]杭州市萧山区第一人民医院肝胆外科, 浙江省杭州311201

出　　处：《中国基层医药》2010年第2期164-165,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨胰岛素强化治疗控制血糖对于老年糖尿病患者并急性梗阻性化脓性胆管炎治疗的临床意义。方法将64例年龄I〉70岁老年糖尿病并急性梗阻性化脓性胆管炎患者分成强化胰岛素治疗组（A组）和非强化治疗组（B组）各32例，A组通过胰岛素泵将目标血糖控制在4．4～6．1nmaol／L；B组当血糖〉11．1mmol／L时使用胰岛素治疗并将目标血糖控制在10．0mmol／L以下。观察两组APACHEII评分变化情况、术后并发症发生情况及住院时间。结果A组在术后第3天APACHEII评分较人院时明显下降[（20．4±4．6）、（24．6±4．5）分，P〈0．01]，A组术后并发症发生率明显低于B组（P〈0．05），A组平均住院时间明显短于B组[（16．5±7．6）、（21．4±8．7）d，P〈0．05]。结论强化胰岛素治疗控制血糖对于老年糖尿病并急性梗阻性化脓性胆管炎患者的临床治疗具有积极意义。Objective To study the clinical effects of the intensive insulin therapy on diabetes with acute ob- structive suppurative cholangitis in elderly patients. Methods Sixty-four patients aged over 70 were divided into two groups：group A （ maintenance of blood glucose at a level between 4. 4 and 6. 1 mmol/L） and group B （ maintenance of blood glucose at a level between 10. 0 and 11.1 mmol/L）. Insulin was infused by mlcro-injection pump. The changes of APACHEⅡ score postoperative complications, average length of stay in hospital and prognosis were observed. Resuits The average APACHEⅡ score of group A was significautly decreased after 3rd day postoperation（ P 〈 0. 01 ）. The average length of stay in hospital of group A was significantly shorter than that of group B（ P 〈 0.05 ）. The postoperative complications of group A were significantly decreased （ P 〈 0. 05 ）. Conclusion Intensive insulin therapy contributes to the outcome of the elderly patients with acute obstructive suppurative cholangitis.

关 键 词：胆管炎 胰岛素输入系统 老年人 

分 类 号：R575[医药卫生—消化系统] R587[医药卫生—内科学]