持续皮下输注速效胰岛素类似物治疗急诊糖尿病酮症酸中毒的临床价值分析  

Clinical Value of Continuous Subcutaneous Infusion of Fast-acting Insulin Analogues in the Treatment of Emergency Diabetic Ketoacidosis

作　　者：王鸿庆 王劲松 朱怡瑄 WANG Hongqing;WANG Jinsong;ZHU Yixuan(Department of Emergency,Anxi County Hospital,Anxi,Fujian Province,352400 China)

机构地区：[1]安溪县医院急诊科,福建泉州352400

出　　处：《糖尿病新世界》2023年第23期169-172,共4页Diabetes New World Magazine

摘　　要：目的 研究持续皮下输注速效胰岛素类似物治疗急诊糖尿病酮症酸中毒的临床效果。方法 选取2021年1月—2023年8月安溪县医院收治的急诊糖尿病酮症酸中毒患者60例,按照随机双盲法分为对照组(30例)和观察组(30例)。对照组采用静脉滴注速效胰岛素治疗,观察组采用持续皮下输注速效胰岛素类似物治疗。对比两组的临床治疗效果、临床恢复指标、血糖指标、酸中毒指标、血钠及血浆渗透压指标、不良反应情况。结果 观察组总有效率为96.67%,高于对照组,差异有统计学意义(χ^(2)=4.027,P=0.039)。观察组患者血糖达标时间、尿酮转阴时间、纠正酸中毒所需时间、空腹血糖、饭后2 h血糖、糖化血红蛋白、β-羟丁酸、乳酸、血酮体、血钠、血浆渗透压均优于对照组,差异有统计学意义(P<0.05)。观察组低血糖、呼吸衰竭不良反应总发生率为6.67%,低于对照组,差异有统计学意义(χ^(2)=8.203,P=0.018)。结论 持续皮下输注速效胰岛素类似物治疗急诊糖尿病酮症酸中毒的临床效果显著优于静脉滴注速效胰岛素治疗。Objective To investigate the clinical effect of continuous subcutaneous infusion of fast-acting insulin analogues in the treatment of emergency diabetic ketoacidosis.Methods 60 patients with emergency diabetic ketoacidosis admitted to Anxi County Hospital from January 2021 to August 2023 were selected and divided into control group(30 cases)and observation group(30 cases)according to random double-blind method.The control group was treated with intravenous infusion of fast-acting insulin,and the observation group was treated with continuous subcutaneous infusion of fast-acting insulin analogues.The clinical therapeutic effect,clinical recovery index,blood glucose index,acidosis index,blood sodium and plasma osmotic pressure index,and adverse reactions of the two groups were compared.Results The total effective rate of observation group was 96.67%higher than that of control group,and the difference was statistically significant(χ^(2)=4.027,P=0.039).Blood glucose compliance time,urine ketone negative time,time required to correct acidosis,fasting blood glucose,2-hour after meal blood glucose,glycated hemoglobin,β-hydroxybutyric acid,lactic acid,blood ketone body,blood sodium and plasma osmotic pressure in observation group were all better than those in control group,and the differences were statistically significant(P<0.05).The total incidence of hypoglycemia and respiratory failure in observation group was 6.67%lower than that in control group,and the difference was statistically significant(χ^(2)=8.203,P=0.018).Conclusion The clinical effect of continuous subcutaneous infusion of fast-acting insulin analogues in the treatment of emergency diabetic ketoacidosis is significantly better than that of intravenous infusion of fast-acting insulin.

关 键 词：糖尿病酮症酸中毒 速效胰岛素 持续皮下输注 不良反应 

分 类 号：R59[医药卫生—内科学]