胰岛素泵治疗糖尿病严重急性并发症的临床观察  

A clinical study on treatment of severe acute diabetes complications with insulin pump

作　　者：张允平[1] 沈默宇[1] 杨科春[1] 薛云[1] 叶新华[1] 薄亚文[1] 李德[1] 胡继红[1] 成金罗[1] 邓向群[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院内分泌代谢科,江苏213003

出　　处：《常州实用医学》2011年第4期219-222,共4页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的比较不同胰岛素给药方法对糖尿病酮症酸中毒和高渗性昏迷高血糖治疗的差异。方法对糖尿病酮症酸中毒和高渗性昏迷患者首先用静脉泵小剂量胰岛素持续输注，在生命体征平稳并能进食半流质后用不同的胰岛素给药方式进行治疗：（1）胰岛素泵持续皮下胰岛素输注；（2）常规4次皮下注射胰岛素治疗。治疗靶目标为空腹血糖≤7．0mmol／L，餐后2小时血糖≤10mmol／，L。结果两组间每日胰岛素用量无显著性差异（P〉0．05），胰岛素泵组较常规组平均达标天数明显缩短（P〈0．001），胰岛素泵治疗组血糖波动小，低血糖次数明显减少，且空腹及晚餐后2小时血糖控制亦明显优于常规组（P〈0．001）。结论在治疗糖尿病严重急性并发症酮症酸中毒和高渗性昏迷时采用静脉泵连续小剂量胰岛素输注后，结合胰岛素皮下泵输注胰岛素较结合常规皮下注射胰岛素模式能更快、更平稳、更有效地控制高血糖。Objective To compare the efficacy of different approaches of insulin delivery on hyperglycemia. Methods The patients with diabetic ketoacidosis or hyperesmolar nonketotic coma were firstly intravenously infused a low dose of insulin. After all cases had got stable vital signs and given semiliquid diet, they were divided into two groups and accepted two differ- ent insulin imemive therapy. （ 1 ） Continuous subcutaneous insulin infusion （CSII） with insulin pump （2） Multi - subucutaneous in- sulin injection（MSII） .The target of blood glueose were fasting glucoses〈 7.0 retool/L,2 - hour postprandial blood glueese ≤ 10 mmol/L.Results The total daily imulin usage had no significant difference between the two groups（ P 〉 0.05） .The patients in CSII group reached the glucose standarch more quickly than that in MSII group（ P 〈 0.001）.In the CSH group,the blood fluctuation and the hypoglycemia frequency were significantly decreased. Conclusion After intravenously infusing a low dose of insulin to patients with diabetic ketoacidosis or hypemsn^lar nonketofic coma, CSII can control hyperglycemia more quickly, equably, and effeotively than MSII.

关 键 词：胰岛素泵 糖尿病酮症酸中毒 糖尿病高渗性昏迷 

分 类 号：R58[医药卫生—内分泌]