胰岛素在高脂血症性胰腺炎合并应激性高血糖中的应用  

Application of insulin in patients with hypertriglyceridemic pancrcatitis and stress hyperglycaemia

作　　者：王玉柱[1] 秦涛[1] 张宏伟[1] 付强[1] 刘传江[1] 薛焕洲[1] 

机构地区：[1]郑州大学人民医院(河南省人民医院)肝胆胰腺外科,450003

出　　处：《中华实验外科杂志》2016年第3期781-783,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨胰岛素在高脂血症性胰腺炎合并应激性高血糖中的作用及临床价值。方法分析本治疗组24例高脂血症性胰腺炎患者，入院时三酰甘油水平〉10mmol/L。根据血糖水平分为胰岛素治疗组（16例）和对照组（8例），分析两组三酰甘油降低水平、腹痛视觉模拟评分法（VAS）评分及住院时间等。结果胰岛素治疗组和对照组的三酰甘油水平〈5．65mmol／L患者百分比在第1个24h分别为56．25％和12．50％，3d为75．00％和25．00％，5d为87．50％和37．50％；腹部疼痛VAS评分胰岛素治疗组第1个24h后为（6．06±1．12）分，对照组为（8．38±0．92）分，3d时两组分别为（3．13±1．20）分和（5．50±1．19）分，两者比较差异均有统计学意义（P〈0．05）；住院时间胰岛素治疗组为（21．2±3．5）d，对照组为（30．6±4．3）d；胰岛素组无低血糖发生，对照组1例患者死于胰周感染和出血。结论静脉应用胰岛素在高脂血症性胰腺炎合并应激性高血糖中是安全和有效的，能迅速降低三酰甘油水平和减轻早期腹痛症状。Objective To investigate the effect of continuous insulin infusion in patients with hy- pertriglyceridemie panereatitis and stress hyperglyeaemia. Methods Retrospective the results of Twenty - four patients were admitted to our hospital with hypertriglyceridemic panereatitis, All patient＇ s with triglye- eride levels 〉 10 mmol/L at admission, According the blood glucose levels divide into regular insulin （RI） and control groups. The triglyceride levels, grade of visual analogue scale （VAS） score and day of dis- charge were observed. Results In first 24 hours, 56. 25% of the RI group, have triglyceride levels below 5.65 mmoL/L, compared with 12. 50% in control group. On day 3, 75.00% of the RI group have triglye- eride below 5.65 retool/L, while only 25.00% in control group. On day 5, 87.50% of RI group, com- pared with 37.50% in control group have triglyceride below 5.65 mmol/L. Abdominal pain VAS in first 24 h and third day was 6.06 ± 1.12 and 3.13 ± 1.20 in RI group with 8.38 ± 0. 92 and 5.50 ± 1.19 in control group （ P 〈 0. 05 ） ; The average length of hospital stay was （ 21.2 ± 3.5 ） d and （ 30. 6 ± 4. 3 ） d in RI and control group respectively, without hypoglyeemie in RI group. One patient in control died of peripanereatie infections and bleeding. Conclusion For patients with hypertriglyceridemia panereatitis and hyperglycemia, intravenous infusion of insulin appears to be a very safe and effective way.

关 键 词：胰岛素 高脂血症 急性胰腺炎 应激性高血糖 

分 类 号：R589.206[医药卫生—内分泌]