高血糖危象患者静脉输注胰岛素向皮下注射速效胰岛素类似物的转换时机研究  

Time of conversion from intravenous insulin infusion to subcutaneous fast-acting insulin injection for hyperglycemic crisis patients

作　　者：盛丽丽 SHENG Li-li(Diabetes Mellitus Department,Traditional Chinese Medical Hospital of Jinzhou District,Dalian 116100,China)

机构地区：[1]大连市金州区中医医院糖尿病科,116100

出　　处：《中国实用医药》2023年第13期121-123,共3页China Practical Medicine

摘　　要：目的 分析高血糖危象患者静脉输注胰岛素向皮下注射速效胰岛素类似物的转换时机。方法 回顾性分析68例高血糖危象患者的临床资料,均予以胰岛素持续静脉泵入,依据速效胰岛素类似物皮下注射不同转换时机分为对照组(30例)和观察组(38例)。对照组在停止静脉输注胰岛素前的1 h予以胰岛素类似物皮下注射,观察组在停止静脉输注胰岛素同时开展速效胰岛素类似物皮下注射。比较两组患者停泵前1 h、停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h的血糖水平以及血糖波动值,同时记录两组患者低血糖发生情况。结果 观察组患者停泵前1 h、停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h血糖水平分别为(15.20±2.54)、(15.64±2.62)、(15.70±2.52)、(16.78±2.62)、(16.92±2.50)、(15.54±2.58)mmol/L,与对照组的(15.38±2.46)、(15.59±2.50)、(15.95±2.56)、(16.12±2.48)、(16.56±2.54)、(15.52±2.60)mmol/L比较,差异均无统计学意义(P>0.05)。观察组患者停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h血糖波动值分别为(0.32±0.10)、(0.38±0.11)、(0.52±0.09)、(0.82±0.12)、(0.11±0.02)mmol/L,与对照组的(0.31±0.10)、(0.40±0.12)、(0.48±0.14)、(0.78±0.15)、(0.10±0.03)mmol/L比较,差异均无统计学意义(P>0.05)。两组于停泵24 h内均未观察到低血糖发生。结论 高血糖危象患者胰岛素静脉输注停止的同时开展速效胰岛素类似物皮下注射能达到胰岛素静脉输注向皮下注射的连续转换,同时将胰岛素水平维持在相对恒定状态,值得采用。Objective To analyze the time of conversion from intravenous insulin infusion to subcutaneous fast-acting insulin injection for hyperglycemic crisis patients.Methods The clinical data of 68 patients with hyperglycemic crisis were retrospectively analyzed,and all of them were given continuous intravenous pumping of insulin,and were divided into control group(30 cases)and observation group(38 cases)according to the different changing time of subcutaneous injection of fast-acting insulin analogues.In the control group,insulin analogs were given subcutaneously 1 h before stopping intravenous insulin infusion,while in the observation group,fast-acting insulin analogs were given subcutaneously at the same time as stopping intravenous insulin infusion.The blood glucose levels and blood glucose fluctuation of 1 h before pump stopping,0.5 h before pump stopping,at the time of pump stopping,0.5 h after pump stopping,1 h after pump stopping and 2 h after pump stopping were compared between the two groups,and the occurrence of hypoglycemia in both groups was also recorded.Results In the observation group,the blood glucose levels were(15.20±2.54),(15.64±2.62),(15.70±2.52),(16.78±2.62),(16.92±2.50)and(15.54±2.58)mmol/L 1 h before pump stopping,0.5 h before pump stopping,at the time of pump stopping,1 h after pump stopping and 2 h after pump stopping,which were not statistically significant compared with(15.38±2.46),(15.59±2.50),(15.95±2.56),(16.12±2.48),(16.56±2.54)and(15.52±2.60)mmol/L in the control group(P>0.05).In the observation group,the blood glucose fluctuation were(0.32±0.10),(0.38±0.11),(0.52±0.09),(0.82±0.12)and(0.11±0.02)mmol/L 0.5 h before pump stopping,at the time of pump stopping,1 h after pump stopping and 2 h after pump stopping,which were(0.31±0.10),(0.40±0.12),(0.48±0.14),(0.78±0.15)and(0.10±0.03)mmol/L in the control group,and the differences between the two groups were not statistically significant(P>0.05).No hypoglycemia was observed in both groups within 24 h of pump stopping.Conclu

关 键 词：胰岛素 静脉输注 高血糖危象 速效胰岛素类似物 皮下注射 转换时机 

分 类 号：R587.2[医药卫生—内分泌]