胰岛素泵在糖尿病酮症酸中毒中应用疗效观察

Obeservations on the effects of insulin pump in treatment of diabetic detoacidosis

目的比较不同胰岛素给药方法对DK或DKA的疗效差异。方法将我科住院DK或DKA病人随机分成持续皮下胰岛素泵治疗组(CSⅡ)和常规小剂量胰岛素静脉滴注组(对照组)各18例,两组年龄、血糖、体重指数(BMI)无显著差异性。观察两组病人血糖、血酮、尿酮变化及低血糖的发生率。结果两组患者的血糖经治疗后均有明显下降,达目标血糖值所需时间:对照组为(4.4±2.1)h,比CSⅡ(5.6±3.2)h要短,但无显著差异(P>0.05)。CSⅡ组血酮恢复时间(3.5±0.7)d,较对照组(4.5±0.5)d明显缩短,具有显著差异(P<0.05);尿酮转阴时间(27.2±11.1)h,亦较对照组(42.2±9.2)h明显缩短,差异具有显著性(P<0.005),CSⅡ组低血糖发生率(0.6±0.2次/人)较对照组(1.2±0.4次/人)明显减少,具有显著性差异(P<0.005)。结论胰岛素泵持续皮下输注胰岛素治疗DKA较常规小剂量静脉滴注胰岛素更安全有效。

Objective To compare the effects of two different ways of insulin delivery on diabetic ketoacidorsis (DKA). Methods 36 patients with DK of DKA were divided to two groups with 18 cases in each insulin pump treated group (CSⅡ groups) and low dose intravenous infusion treated group (control group), Patients in two groups were watched in age, blood glucose and BMI. The average recoveriny time of blood glucose, blood ketoacidosis and urinary ketoacidosis and the frequency of bypoglycemia incidences were observed in two groups. Rusults the level of blood glucose control in two groups is similar after treatment, it took (4.4±2.1)h in CSⅡ and (5.6±3.2)h in control group to recover blood glucose. There was a significantly different in two groups of the recoveriry time of blood ketiacidosis CSⅡ group(3.5±0.7)d, control group (4.5±0.5)d, (P<0.05). It took (27.2±11.1)h CSⅡ group and (42.2±9.2) in control group to reverse he urinary ketiacidosis which were significantly different (P<0.05). The frequency of hypoglycemia incidences in CSⅡ group was (0.6±0.2times/case) and in control group was (1.2±0.4 times/case)(P<0.05). Conclusions The treatment of insulin pump was more effectively and safely than intravenous insulin infusion in patients with DKA.