胰岛素泵持续皮下输注胰岛素对急诊糖尿病酮症酸中毒患者的临床效果研究  

Clinical Efficacy of Continuous Subcutaneous Insulin Infusion with Insulin Pumps in Emergency Patients with Diabetic Ketoacidosis

作　　者：张谦 ZHANG Qian(Department of Intensive Care Medicine,The People's Hospital Of Huaiyin Jinan,Jinan 250021,China)

机构地区：[1]济南市槐荫人民医院重症医学科,山东济南250021

出　　处：《中华灾害救援医学》2025年第2期172-176,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨胰岛素泵持续皮下输注给药方式在糖尿病酮症酸中毒(DKA)患者治疗中的临床效果与应用价值。方法回顾性分析2022年1月至2024年9月在济南市槐荫人民医院接受治疗的70例糖尿病酮症酸中毒患者的临床资料。根据不同胰岛素输注方式,分为观察组和对照组,每组35例,观察组予以胰岛素泵治疗,对照组以小剂量胰岛素持续静脉滴注治疗。对两组患者的血糖、血酮体水平、酮症酸中毒相关指标、氧化应激标志物、临床生化指标恢复时间及治疗效果进行比较分析。结果两组患者治疗后的空腹血糖、餐后2小时血糖及血酮体水平均显著降低,且观察组的血糖和血酮体水平显著低于对照组(P<0.05)。同时,治疗后两组患者的血pH值较治疗前明显升高,观察组的血pH值高于对照组(P<0.05)。观察组患者的血糖恢复正常、尿酮体转阴、血酮体转阴所需时间,以及血浆pH恢复正常时间均较对照组明显更短(P<0.001)。两组患者治疗后的MDA水平较治疗前显著降低(P<0.001),且观察组MDA水平较对照组更低(P<0.001)。两组患者的SOD和GSH-Px水平较治疗前显著升高(P<0.001),且观察组较对照组升高更显著(P<0.05)。观察组患者的总有效率显著高于对照组(P<0.05)。结论胰岛素泵持续皮下输注能够有效降低糖尿病酮症酸中毒患者的血糖及血酮体水平,缩短血糖和酮体恢复的时间,改善氧化应激状态,并取得较好的临床治疗效果。Objective To explore the clinical effectiveness and application value of continuous subcutaneous insulin infusion via insulin pump in the treatment of patients with diabetic ketoacidosis(DKA).Methods The clinical data of 70 patients with diabetes ketoacidosis who were treated in Huaiyin People's Hospital from January 2022 to September 2024 were analyzed retrospectively.According to different insulin infusion methods,the patients were divided into an observation group and a control group,with 35 cases in each group.The observation group received insulin pump treatment,while the control group received continuous intravenous infusion of low-dose insulin treatment.The two groups were compared in terms of blood glucose levels,blood ketone levels,DKA-related parameters,oxidative stress markers,the time taken for recovery of clinical biochemical indices,and overall treatment efficacy.Results After treatment,the fasting blood glucose,postprandial blood glucose(2 hours after a meal),and blood ketone levels in both groups significantly decreased compared to pre-treatment levels,with the observation group exhibiting significantly lower blood glucose and ketone levels than the control group(P<0.05).Additionally,blood pH levels significantly increased post-treatment in both groups,with the observation group showing higher pH levels than the control group(P<0.05).The time required for blood glucose normalization,urine ketone body conversion to negative,blood ketone body conversion to negative,and plasma pH normalization was significantly shorter in the observation group compared to the control group(P<0.001).Furthermore,both groups exhibited a significant reduction in malondialdehyde(MDA)levels post-treatment(P<0.001),with the observation group having lower MDA levels than the control group(P<0.001).Both groups showed a significant increase in superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)levels post-treatment(P<0.001),with SOD levels notably higher in the observation group compared to the control group(P<0.05).Th

关 键 词：糖尿病酮症酸中毒 胰岛素泵持续皮下输注 临床疗效 

分 类 号：R587.1[医药卫生—内分泌]