胰岛素泵治疗糖尿病酮症酸中毒的研究

Study of insulin pump on diabetic ketoacidosis

目的 探讨胰岛素泵持续皮下输注胰岛素对血糖、血脂控制及延缓并发症的作用。方法 我院住院糖尿病酮症酸中毒患者 75例 ,分为治疗组 (37例 )和对照组 (38例 ) ,分别使用胰岛素泵皮下输注胰岛素和小剂量胰岛素静脉滴注 ,常规胰岛素的用量为 0 .10IU/ (kg·h) ,待血糖降至 13.9mmol/L时 ,对照组改为胰岛素多次注射 ,治疗组则继续使用胰岛素泵。观察血糖、血 pH或CO2 CP、尿酮体、血脂的变化 ,以及胰岛素剂量、平均治愈时间、低血糖发生率等。结果 ① 2组患者的血糖在治疗后均明显下降 ,无显著性差异。② 2组患者的酸中毒在治疗后均得到纠正 ,血 pH或CO2 CP恢复正常 ,治疗组恢复正常时间 ((8.2± 2 .0 )h)短于对照组((14 .0± 3.0 )h) ,2组有非常显著性差异 (t=9.6 6 ,P <0 .0 1)。③治疗组治疗后尿酮体转阴时间为 (9.2± 2 .2 )h ,对照组为 (14 .5± 2 .5 )h ,2组有显著性差异 (t=9.73,P <0 .0 1)。④治疗组血脂较对照组明显改善。结论 胰岛素泵治疗糖尿病酮症酸中毒可以取得比对照组更满意的疗效。

Objective It is to discuss the action of insulin infus ed with insulin pump unremittingly and subcutaneouly on blood sugar, serum lipid and delay compl ication. Methods 75 patients with diabetic ketoacidosis in hospita l were divided into treatment group (37 cases) and control group (38 cases), and were given in sulin infused with insulin pump subcutaneouly and low dose intravenous infusion insulin. The dose of regular insulin was 0.10 IU/(kg·h). When blood sugar desce nded below 13.9 mmol/L, the control group changed to multi-subcutaneous insulin injection, but the treated group was infused with insulin pump continue. The cha nges of blood sugar, pH or CO 2CP, urine acetone body and serum lipid, and insu li n dosage, average cure time and incidence rate of low blood sugar were observed. Results ①Blood sugar in the two groups both descended obviously after treatmen t, there was not significantly difference. ②The acidosis in the two groups both got rectification after treatment. The level of pH or CO 2CP recovered to norm al . The recovering time in treatment group ((8.2±2.0)h) was shorter than that in control group ((14.0±3.0)h), and there was very significantly difference (t=9 .66, P<0 01). ③The time of urine acetone body turning to negative in treatme n t group after treatment was (9.2±2.2)h and that in control group was (14.5±2.5 )h, and there was significantly difference (t=9.73, P<0.01). ④Serum lipid i n treatm ent group improved obviously compared with control group. Conclusion Insulin pump may get more satisfactory curative effect on diabetic ketoacidosis.