不同血糖调控方式用于腹部中等以上手术术后行肠外营养支持的糖尿病患者的临床效果比较  

Comparision glucose control between two methods of blood glucose regulation in patients receiving parenteral nutrition after abdominal surgery ranked above medium

作　　者：杨靓靓[1] 卞晓洁[2] 葛卫红[2] 于锋[1] 

机构地区：[1]中国药科大学临床药学教研室,南京市210009 [2]南京大学医学院附属鼓楼医院药剂科,南京市210008

出　　处：《临床合理用药杂志》2016年第5期7-8,10,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨接受肠外营养支持的腹部中等以上手术的糖尿病患者两种血糖调控方式的有效性和安全性。方法回顾性分析27例接受腹部中等以上手术的糖尿病患者术后使用肠外营养时的血糖监测结果,将其血糖调控方式分为将胰岛素按比例加入营养液(全合一法,IPN)和胰岛素静脉微量泵入法(IIM),分别比较2种血糖调控方式的晨间和全部血糖中位数、最大血糖波动幅度(LAGE)、低血糖和高血糖事件的发生率、血糖达标率。结果糖尿病患者使用TNA第2、3、4、5天晨间血糖中位数IIM组比IPN组低,其中第2、3、5天的差异具有统计学意义(P<0.05);2组全部血糖的中位数IIM组比IPN组低,差异具有统计学意义(P<0.01)。IIM组的LAGE值均小于IPN组,其中第1、2、3天差异具有统计学意义(P<0.01)。IIM组的高血糖事件发生率低于IPN组,且具有显著性差异(P<0.01),而低血糖事件发生率及达标率差异无统计学意义(P>0.05)。结论腹部中等以上术后肠外营养输注期间,糖尿病患者IIM血糖调控方式优于IPN。Objective To discuss the efficacy and safety of two methods of glycemic control in diabetes patients who recived parenteral nutrition support after abdominal surgery ranked above medium. Methods Analyze respoctively glycemic monitoring results of 27 diabetes patients who recived parenteral nutrition support after abdominal surgery ranked above medium,the glycemic control methods can be divided into adding insulin in parenteral nutrient（ IPN） and intravenous insulin by minim pump（ IIM）,compared median of morning blood glucose and all blood glucose,LAGE,the incidence of hypoglycemia and hyperglycemia and goal control rate of two methods glycemic control. Results In the diabetic,median of morning blood glucose using TNA 2,3,4,5 days in IIM group was lower than IPN,and there are statistically differences in 2,3,5 days（ P 〈0. 05）; the median of all blood glucose in IIM was lower than IPN,and there are statistically differences in all days（ P 〈0. 01）. LAGE of IIM are less than that of IPN,and there are statistically differences in 1,2,3 days（ P 〈 0. 01）. The incidence of high blood glucose events of IIM group was lower than IPN group,with significant difference in all days（ P 〈 0. 01）,while there was no statistically significant difference of hypoglycemic events and success rate（ P 〉 0. 05）. Conclusion In diabetes patients who recived parenteral nutrition support after abdominal surgery ranked above medium,IIM way may be better than IPN in glucose control for the diabetic.

关 键 词：肠外营养 血糖调控 全合一法 微量泵入法 

分 类 号：R587.1[医药卫生—内分泌] R459.3[医药卫生—内科学]