研究胰岛素泵联合胃管补液治疗糖尿病酮症酸中毒并高渗昏迷的临床有效性  

Clinical Efficacy of Insulin Pump Combined with Gastric Tube Rehydration in the Treatment of Diabetic Ketoacidosis and Hyperosmotic Coma

作　　者：杨硕 张志伟 李新茹 YANG Shuo;ZHANG Zhiwei;LI Xinru(Department of Critical Care Medicine,Juye County People's Hospital,Heze 274900,Shandong,China;Department of Endocrinology,Juye County People's Hospital,Heze 274900,Shandong,China)

机构地区：[1]巨野县人民医院重症医学科,山东菏泽274900 [2]巨野县人民医院内分泌科,山东菏泽274900

出　　处：《糖尿病新世界》2024年第23期184-186,190,共4页Diabetes New World

摘　　要：目的 探讨胰岛素泵联合胃管补液治疗糖尿病酮症酸中毒并高渗昏迷的效果。方法 回顾性选取2022年7月-2024年6月巨野县人民医院收治的50例糖尿病酮症酸中毒并高渗昏迷患者的临床资料,根据治疗方式的不同分为两组,各25例。参照组采用胃管补液结合静脉滴注胰岛素治疗,探究组采用胰岛素泵结合胃管补液治疗。比较两组临床疗效、临床指标、氧化应激指标和炎症反应指标水平。结果 探究组治疗总有效率高于参照组,差异有统计学意义(P<0.05)。探究组血酮体转阴时间、血糖达标时间、尿酮体转阴时间、血浆p H恢复时间均短于参照组,胰岛素用量少于参照组,差异均有统计学意义(P均<0.05)。治疗后,探究组超氧化物歧化酶水平高于参照组,丙二醛、C反应蛋白和白细胞介素-6水平均低于参照组,差异均有统计学意义(P均<0.05)。结论 胰岛素泵联合胃管补液治疗糖尿病酮症酸中毒并高渗昏迷的疗效显著,具有一定的临床应用价值。Objective To investigate the effect of insulin pump combined with gastric tube rehydration in the treat-ment of diabetic ketoacidosis and hypertonic coma.Methods The clinical data of 50 patients with diabetic ketoacido-sis and hyperosmolar coma admitted to Juye County People's Hospital from July 2022 to June 2024 were retrospec-tively selected and divided into two groups according to different treatment methods,with 25 cases in each group.The reference group was treated with gastric tube rehydration combined with intravenous infusion of insulin,and the study group was treated with insulin pump combined with gastric tube rehydration.The clinical efficacy,clinical indicators,oxidative stress indicators and inflammatory response indicators were compared between the two groups.Results The total effective rate of treatment in the study group was higher than that in the reference group,and the difference was statistically significant(P<0.05).The blood ketone body negative conversion time,blood glucose standard time,urine ketone body negative conversion time,plasma pH recovery time in the study group were shorter than those in the refer-ence group,and the insulin dosage was less than that in the reference group,the differences were statistically signifi-cant(all P<0.05).After treatment,the level of superoxide dismutase in the study group was higher than that in the ref-erence group,and the levels of malondialdehyde,C-reactive protein and interleukin-6 were lower than those in the reference group,the differences were statistically significant(all P<0.05).Conclusion Insulin pump combined with gastric tube rehydration is effective in the treatment of diabetic ketoacidosis and hyperosmolar coma,and has certain clinical application value.

关 键 词：糖尿病酮症酸中毒 高渗昏迷 胰岛素泵 胃管补液 氧化应激 

分 类 号：R587.2[医药卫生—内分泌]