胰岛素泵在糖尿病合并结直肠癌术后全肠外营养支持中的应用  

Application of insulin pump in total parenteral nutrition support for patients with diabetes complicated with colorectal cancer

作　　者：梁玮秦 刘小芳 李石梅 陈小波 LIANG Wei-qin;LIU Xiao-fang;LI Shi-mei;CHEN Xiao-bo(Department of Rehabilitation,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000;Department of Traditional Chinese Medicine,The Second Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一附属医院康复医学科,江西赣州341000 [2]赣南医科大学第二附属医院中医科,江西赣州341000

出　　处：《赣南医学院学报》2024年第3期239-243,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生健康委员会计划项目(20204506)。

摘　　要：目的:探讨胰岛素泵持续皮下胰岛素输注在糖尿病合并结直肠癌术后全肠外营养支持中的应用效果。方法:选择结直肠癌术后行全肠外营养治疗(Total parenteral nutrition,TPN)的2型糖尿病患者64例,随机分成胰岛素泵持续皮下输注人胰岛素(胰岛素泵组)和人胰岛素微量注射泵持续静脉泵入(静脉泵组)。分别监测2组患者葡萄糖目标范围内时间(Time in range,TIR)、葡萄糖高于目标范围时间(Time above range,TAR)、葡萄糖低于目标范围时间(Time below range,TBR)、平均血糖波动幅度(Mean blood glucose fluctuation amplitude,MAGE)、低血糖发生情况。结果:胰岛素泵组TIR值高于静脉泵组[(76.72±8.54)%vs(72.12±8.34)%],差异有统计学意义(P<0.05);胰岛素泵组TBR值低于静脉泵组[(13.72±5.28)%vs(16.72±5.00)%],差异有统计学意义(P<0.05);胰岛素泵组MAGE较静脉泵组血糖波动更小[(2.83±1.06)mmol·L^(-1)vs(3.39±1.06)mmol·L^(-1)],差异有统计学意义(P<0.05);2组TAR值差异无统计学意义(P>0.05);2组患者低血糖发生事件因样本量太小,无比较意义。结论:胰岛素泵用于控制糖尿病合并结直肠癌术后TPN患者血糖与静脉泵注胰岛素相比,TIR值更好,血糖更加平稳。Objective:To investigate the effect of continuous subcutaneous insulin infusion with insulin pump in total parenteral nutrition support for patients with diabetes after colorectal cancer surgery.Methods:A total of 64 patients with type 2 diabetes who received total parenteral nutrition(TPN)after colorectal cancer surgery were randomly divided into two groups:continuous subcutaneous insulin infusion(insulin pump group)and continuous intravenous insulin infusion(intravenous pump group).Monitoring was done about the glucose target time(TIR),glucose above target range time(TAR),glucose below target range time(TBR),mean blood glucose fluctuation amplitude(MAGE),and incidence of hypoglycemia in two groups of patients.Results:The TIR value of the insulin pump group was higher than that of the venous pump group[(76.72±8.54)%vs(72.12±8.34)%],and the difference was statistically significant(P<0.05);The TBR value of the insulin pump group was lower than that of the venous pump group[(13.72±5.28)%vs(16.72±5.00)%],and the difference was statistically significant(P<0.05);The MAGE of the insulin pump group had smaller blood glucose fluctuations compared to the venous pump group[(2.83±1.06)mmol·L^(-1)vs(3.39±1.06)mmol·L^(-1)],and the difference was statistically significant(P<0.05);There was no statistically significant difference in TAR values between the two groups(P>0.05).There was no comparative significance of the occurrence of hypoglycemia between the two groups due to the small sample size.Conclusion:Compared with intravenous infusion of insulin,the TIR value of insulin pump used to control the blood sugar of TPN patients with diabetes complicated with colorectal cancer is better and the blood sugar is more stable.

关 键 词：胰岛素泵 葡萄糖目标范围内时间 血糖波动 全肠外营养 

分 类 号：R473.5[医药卫生—护理学]