动态血糖监测系统联合胰岛素泵在接受生长激素治疗的糖尿病烧伤患者中的应用  

Application of Continuous Glucose Monitoring System Combined with Insulin Pump in Burn Patients with Diabetes Mellitus Receiving Growth Hormone Therapy

作　　者：周锦烽[1] 刘雄飞[1] 徐昌政[1] 邹忠桃[1] 郝超[1] 

机构地区：[1]南京医科大学附属南京医院烧伤整形科,江苏南京210006

出　　处：《医学临床研究》2012年第12期2355-2357,共3页Journal of Clinical Research

摘　　要：[目的]探讨糖尿病烧伤患者接受重组人生长激素（rhGH）治疗后血糖调控的有效方法。[方法]12例合并糖尿病的中重度烧伤患者入院后即密切监测其血糖水平，并以胰岛素泵调控血糖，血糖迭标后，注射rh—GH治疗，并于注射rhGH的当天佩戴动态血糖监测系统（CGMS）。3d后取下CGMS，分析血糖波动情况，调整胰岛素剂量或加用二甲双胍、拜糖平进行血糖精细调节。[结果]经治疗后，7例患者通过定期换药创面自愈，创面愈合时间为16-25d；5例患者通过手术治疗而愈合，创面愈合时间28-51d。12例患者血糖达标需要时间7～13（8．1±2．3）d。佩戴CGMS后，所有患者均未发生严重的低血糖不良反应。[结论]糖尿病烧伤患者应用rh-GH后，使用CGMS联合胰岛素泵持续皮下输注胰岛素，可快速、平稳的调控血糖，值得临床推广应用。[Objective] To explore the effective method for the regulation of glucose in burn patients with diabetes mellitus receiving recombinant human growth hormone（rhGH） therapy. [Methods] After admission, blood glucose level of 12 severe burn patients with diabetes mellitus were closely monitored. Insulin pump was used to control the blood glucose levels. After blood glucose reaching the standard, all patients were treated with rhGH , and wore continuous glucose monitoring system（CGMS） on the day of rhGH injection. Three days later, CGMS was removed. Blood glucose fluctuation was analyzed. Then insulin dose was adjusted or metformin and acarbose were added to regulate the blood glucose levels. [Results] After treatment, 7 patients were healed by periodic dressing, and the wound healing time was 16- 25d. Five patients were healed by operation, and the wound healing time was 28-51d. The time of blood glucose reaching the standard was 7-13d with the average of 8.1-2.3d. After wearing CGMS, all patients had no severe hypoglycemia adverse reaction. [Conclusion] CGMS combined with insulin pump for continuous insulin subcutaneous injection for the treatment of burn patients with diabetes mellitus after rhGH therapy can rapidly and stably control the blood glucose levels. Therefore, it is worthy of clinical application.

关 键 词：糖尿病 并发症 烧伤 并发症 糖尿病 药物疗法 生长激素(人) 治疗应用 血糖 分析 胰岛素 投药和剂量 

分 类 号：R587.1[医药卫生—内分泌]