动态调节胰岛素泵入量在冠状动脉旁路移植术后血糖控制的效果评价  

Effects of dynamicly adjusting insulin pump intake to control blood glucose after coronary artery bypass grafting

作　　者：李娜[1] 生伟[1] 尹红[1] 

机构地区：[1]青岛市市立医院心外科,山东青岛266071

出　　处：《中国医药科学》2015年第22期24-26,123,共4页China Medicine And Pharmacy

基　　金：山东省青岛市医药科研指导计划项目(2014-WJZD030)

摘　　要：目的探讨冠状动脉旁路移植术（CABG）后动态调节胰岛素泵入量控制血糖的效果。方法 2013年10月-2014年10月选取就诊于青岛市市立医院心外科选择CABG的患者121例,随机分为观察组（65例）和对照组（56例）,观察组术后给予微量泵持续注射普通胰岛素（40U胰岛素＋20m L生理盐水）,在患者进食前将胰岛素泵入量调高2~4U/h,在进食2h后,根据血糖结果再调整胰岛素泵入量。对照组根据血糖监测结果调整胰岛素泵入量,比较两组治疗效果。结果观察组术后无低血糖发生,对照组5例,差异有统计学意义（P〈0.05）;观察组术后血糖波动小,无伤口感染;对照组发生伤口感染4例,差异有统计学意义（P〈0.05）。结论选择动态调节胰岛素泵入量血糖控制方法,可有效的控制血糖在稳定的范围,减少CABG术后并发症的发生率,提高手术治疗效果,促进患者的康复。Objective To discuss the effects of dynamicly adjusting insulin pump intake to control blood glucose after coronary artery bypass grafting（CABG）. Methods A total of 121 patients undergoing coronary artery bypass surgery between October 2013 and October 2013 were divided into observation group（n=65）and control group（n=56）.Insulin（40U Insulin＋20m L normal saline）was infused by micro-pump in observation group,The amount of insulin was increased by 2U/h-4U/h before the meal,the insulin pump dose after two hours was adjusted according to the results of blood glucose.Insulin was infused by micro-pump according to the results of blood glucose in control group.Then the therapeutic effects of the two groups were assessed. Results There was no hypoglycemia occurred in the observation group and 5 cases in the control group,the difference was statistically significant（P〈0.05）.The blood glucose fluctuation was small and there was no wound infection,but there were 4 cases of wound infection in the control group, the difference was statistically significant（P〈0.05）. Conclusion Dynamic regulation of insulin pump in the amount of blood glucose control method,can effectively control blood glucose in the range of stability,reduce the incidence of complications after CABG operation,improve surgical treatment effect, and promote the rehabilitation of patients.

关 键 词：冠状动脉旁路移植术 血糖控制 胰岛素 微量泵 动态调节 

分 类 号：R654.2[医药卫生—外科学]