胰岛素泵强化治疗对脊柱疾病合并糖尿病患者脊柱术后切口愈合的影响  

Effect of Insulin Pump Intensified Treatment on Postoperative Wound Healing in Diabetic Patients Complicated with Spinal Disease

作　　者：彭翠云[1] 王耀生 方剑 张鑫博 吴妞 马双[1] PENG Cuiyun;WANG Yaosheng;FANG Jian;ZHANG Xinbo;WU Niu;MA Shuang(Department of Spinal Surgery,Sanmenxia Hospital of the Yellow River,Sanmenxia 472000,China)

机构地区：[1]黄河三门峡医院脊柱外科,河南三门峡472000

出　　处：《转化医学杂志》2024年第9期1494-1497,1502,共5页Translational Medicine Journal

摘　　要：目的探究胰岛素泵强化治疗对脊柱疾病合并糖尿病患者脊柱术后切口愈合的影响。方法以2023年1月至2023年12月黄河三门峡医院脊柱外科住院手术治疗的脊柱疾病合并糖尿病患者120例为研究对象,按照随机数字表法分为研究组和对照组,每组60例,研究组患者在围手术期采取胰岛素泵强化治疗,对照组患者采取常规胰岛素(或口服药)降糖治疗。比较2组患者术前、术后1 d、术后3 d、术后7 d以及术后14 d空腹血糖、餐后2 h血糖水平。并统计比较2组患者血糖达标时间、低血糖发生率及术后住院时间。比较2组患者术后10 d切口愈合情况及术前、术后14 d炎症指标白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平。结果2组术后1 d空腹血糖、餐后2 h血糖水平有所回升,术后3 d、7 d、14 d空腹血糖、餐后2 h血糖均下降,且研究组术后1 d、术后3 d、术后7 d及术后14 d空腹血糖、餐后2 h血糖均低于对照组同期(P<0.05)。研究组患者切口愈合情况优于对照组(P<0.05)。研究组血糖达标时间及住院时间均短于对照组(P<0.05),低血糖发生率高于对照组(P<0.05)。术后14 d 2组患者IL-6、CRP、TNF-α水平均较本组术前明显降低(P<0.05),且术后14 d研究组IL-6、CRP、TNF-α水平均低于对照组(P<0.05)。结论胰岛素泵强化治疗可显著改善脊柱疾病合并糖尿病患者脊柱术后切口愈合情况。Objective To study the effect of insulin pump intensified treatment on postoperative wound healing in diabetic patients complicated with spinal disease.Methods From January 2023 to December 2023,A total of 120 diabetic patients complicated with spinal disease who underwent surgery in our hospital were selected as the research objects.The patients in the study group received insulin pump intensified treatment during the perioperative period,while the patients in the control group received conventional insulin hypoglycemic treatment.Both groups were treated for 2 weeks.The differences between the two groups in blood glucose,blood lipids,wound healing,blood glucose standardization and hypoglycemia were compared.Results After treatment,the levels of preprandial blood glucose and two hour postprandial blood glucose of patients in both groups increased at 1 day and 3 days postoperatively.The levels of preprandial blood glucose and two hour postprandial blood glucose significantly decreased at 7 days and 14 days postoperatively.In addition,the levels of preprandial blood glucose and two hour postprandial blood glucose in the study group were significantly lower than those in the control group at 1 day,3 days postoperatively,7 days postoperatively,and 14 days postoperatively(P<0.05).The wound healing in the study group was better than that in the control group(P<0.05),and the incidence of blood glucose compliance and hospitalization time in the study group was lower than that in the control group,while the incidence of hypoglycemia in the study group was higher than that in the control group(P<0.05).After operation,the inflammatory indexes in the two groups were significantly decreased,and the inflammatory indexes in the study group were lower than those in the control group(P<0.05).Conclusion Insulin pump intensified treatment can significantly improve postoperative wound healing in diabetic patients complicated with spinal disease,which is worthy of clinical promotion and application.

关 键 词：脊柱手术 伤口愈合 胰岛素泵 

分 类 号：R681.5[医药卫生—骨科学] R619.5[医药卫生—外科学] R587.1[医药卫生—临床医学]