3C疗法在垂体生长激素瘤合并糖尿病患者围术期的临床应用  

Effects of 3C therapy in patients with pituitary growth hormone tumor complicated with diabetes during the perioperative period

作　　者：李明[1] 沈艳军[1] 彭兰博[1] 孙洁[1] 段洪刚[1] 田亚强[1] 

机构地区：[1]山东省聊城市人民医院内分泌科,252000

出　　处：《中华糖尿病杂志》2017年第7期446-449,共4页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的 探讨动态3C疗法在垂体生长激素瘤合并糖尿病患者围术期的临床应用效果.方法 选取2013年6月至2016年6月于山东省聊城市人民医院住院的垂体生长激素瘤合并糖尿病患者,共60例,随机数字表法分为对照组和实验组,每组各30例,对照组应用基础-餐时胰岛素治疗,实验组采用3C方案监测治疗.比较整个围手术期两组患者血糖控制情况、血糖波动幅度、胰岛素用量、低血糖发生率、术前血糖达标时间、糖化血清蛋白等情况.组间数据比较采用两独立样本t检验.结果 实验组整个围术期血糖控制情况优于对照组,空腹血糖及餐后血糖均较对照组降低（t=8.688、5.016,均P〈0.05）,实验组术前血糖达标时间短于对照组[（4.7±1.3）比（8.1±2.2）d,t=4.823,P〈0.05],糖化血清蛋白水平明显优低于对照组[（152±31）比（186±51）μmol/L,t=10.523,P〈0.05],实验组胰岛素用量更少[（36±9）比（40±13）U/d,t=4.461,P〈0.05],低血糖发生率更低[（5.2±1.2）%比（9.1±2.3）%,t=5.333,P〈0.05],特别是在手术当天、术后生长激素水平变化较为显著的特殊阶段,实验组在减少血糖波动幅度及低血糖发生率方面显示出更大的优势（t=4.590-9.519,均P〈0.05）.结论 3C治疗系统可实时动态监测血糖,反映血糖变化趋势,能够安全、快速、有效的控制血糖,在垂体生长激素瘤围手术期的血糖管理中具有独特的优势.Objective To investigate the therapeutic effects of dynamic 3C therapy in patients with pituitary growth hormone tumor complicated with diabetes during the perioperative period. Methods A total of 60 inpatients with pituitary growth hormone tumor complicated with diabetes hospitalized in Liaocheng People＆#39;s Hospital from June 2013 to June 2016 were enrolled in this study. The patients were divided into control group and treatment group according to the random number table with 30 cases in each group. Basic-meal insulin therapy was used in the control group while 3C program monitoring therapy was applied in the treatment group. The blood glucose control, glucose fluctuation range, insulin dosage, hypoglycemia incidence, standard time of preoperative glucose and glycosylated serum protein （GSP） were compared during the whole perioperative period between the two groups. Double independent-sample t test was adopted for data comparisons between groups. Results The glycemic control in the treatment group was superior to control group in the whole perioperative period. Fasting blood-glucose （FPG） and 2 hours postprandial blood glucose （2hPG） in treatment group reduced significantly when compared with those in control group （t=8.688, 5.016, both P〈0.05）. The time needed to return the set level of FPG was shorter [（4.7 ± 1.3）vs（8.1 ± 2.2）d], the GSP was significantly lower [（152 ± 31） vs （186 ± 51）μmol/L] and the insulin dosage was remarkably lower [（36±9） vs （40±13）U/d] in the treatment group when compared with those in the control group （t=4.823, 10.523, 4.461, all P〈0.05）. And the incidence of hypoglycemia was also markedly lower in the treatment group （5.2%± 1.2%vs 9.1%± 2.3%, t=5.333, P〈0.05）. Particularly on the operation day and during the postoperative days with descending growth hormone, the glucose fluctuation and the incidence of hypoglycemia were both much milder in treatment group than those in control group（t=4.590-9.519, all P〈0.05） i

关 键 词：糖尿病 垂体生长激素瘤 围手术期 持续胰岛素皮下输注 实时动态血糖监测 

分 类 号：R736.402[医药卫生—肿瘤]