多次胰岛素皮下注射和胰岛素泵治疗糖尿病酮症酸中毒的疗效比较  

Effects comparison of repeated subcutaneous injection of insulin and insulin pump therapy for diabetic ketoacidosis

作　　者：龙碧 

机构地区：[1]重庆市永川区人民医院内分泌科,重庆402160

出　　处：《海南医学院学报》2011年第11期1488-1490,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020110409)~~

摘　　要：目的:比较多次胰岛素皮下注射和胰岛素泵治疗糖尿病酮症酸中毒的临床疗效。方法:将我院2008年2月～2010年8月收治的糖尿病酮症酸中毒的患者84例随机分为皮下注射组和胰岛素泵组,每组42例,皮下注射组患者给予多次胰岛素皮下注射治疗,初始用量0.1U/(kg.h),至血糖降至13.9mmol/L后改为5%葡萄糖水与胰岛素混合液静脉滴注,待酸中毒纠正,尿酮转阴后改为皮下注射胰岛素治疗。胰岛素泵组患者给予胰岛素泵持续皮下泵人胰岛素0.1U/kg.h),待酸中毒纠正,尿酮转阴后改为基础量加餐前负荷量持续皮下输注胰岛素。观察两组患者治疗后平均血糖、二氧化碳结合力、尿酮体转阴时间及不良反应情况等。结果:两组患者治疗后血糖和二氧化碳结合力均有所好转,与治疗前比较差异有统计学意义(P<0.05);治疗后两组患者平均血糖和二氧化碳结合力差异无统计学意义(P>0.05)。胰岛素泵组尿酮转阴时间较皮下注射组短;低血糖发生率较皮下注射组低,且平均胰岛素用量较皮下注射组低(P<0.05)。结论:胰岛素泵持续皮下泵入胰岛素治疗酮症酸中毒疗效较好,不良反应较常规多次皮下注射胰岛素低。Objective： To compare effects of repeated subcutaneous injection of insulin and insulin pump therapy for diabetic ketoacidosis. Methods： A total of 84 patients with diabetic ketoacidosis were randomly divided into subcutaneous insulin group and insulin pump group, with 42 eases in each group. Patients in the subcutaneous insulin group were given repeated subcutaneous injection at the dosage of 0.1U / （kg. h） first;then injection was changed to be 5% mixture of glucose and insulin when blood glucose decreased to be 13.9 mmol/L. After acidosis was corrected and ketone turned to be negative, insulin was given subcutaneously again. The insulin pump group was given insulin at the dosage of 0.1U / （kg. h） first. After acidosis was corrected and ketone turned to be negative, insulin at the dosage of baseline level plus was preprandial load was continuously given subcutaneously. After treatment, average blood glucose level, carbon dioxide combining power, ketone clearance time and adverse reactions of the two groups were compared. Results： After treatment, both groups showed significant improvements in blood glucose level, carbon dioxide combining power （P〈0.05）, but no significant difference in the two indicators was ob- served between the two groups （P〉0. 05）. The insulin pump group showed significant shorter ketone clearance time, lower incidence of hypoglycemia, as well as less consumption of insulin comparing with the subcutaneous insulin group（P^0.05）. Conclusions： Continuous subcutaneous insulin infusion pump treatment shows better effects, less adverse reactions than conventional repeated subcutaneous insulin therapy.

关 键 词：糖尿病 酮症酸中毒 胰岛素泵 胰岛素皮下注射 

分 类 号：R587.1[医药卫生—内分泌]