强化胰岛素治疗在危重病患者中的临床疗效观察

Clinical observation of intensive insulin therapy in the critical illness patients

目的 研究强化胰岛素治疗在危重病患者中的临床疗效。方法 6 0例危重病患者血糖水平为18 .34±6 73mmol/L ,随机分为治疗组(n =30 )给予强化胰岛素治疗,使血糖控制在4 . 4～6 . 1mmol/L ;对照组(n =30 )给予常规胰岛素治疗,使血糖控制在10 .0～11. 7mmol/L。观察两组患者静滴胰岛素天数、使用抗生素天数、入住ICU天数、出现死亡天数、院内感染发生率、死亡率等反映病情疗效的参数。结果 治疗组中静滴胰岛素天数(10. 0±2 . 8)d、使用抗生素天数(14. 5±3 .4 )d、入住ICU天数(11 .0±4 . 6 )d、出现死亡天数(7 ,5±2 .8)d、院内感染发生率(13, 3% )、死亡率(16. 5 % )均明显低于对照组(P <0 . 0 5 ) ,有显著性差异。结论 对于危重病患者即使无糖尿病,当出现血糖水平持续升高时,强化胰岛素治疗可改善危重病患者的病情,降低死亡率。

Objective To investigate the effect of intensive insulin therapy on the critical illness patients.Methods Sixty cases of critical illness patients were randomly divided into treatment group and control group. Treatment group ( n =30) received intensive insulin therapy, the blood glucose levels were preserved 4.4～6.1 mmol/L. While the control group ( n =30) received routine insulin therapy, the blood glucose levels were preserved 10.0～11.7 mmol/L. The days of mainline insulin, the days of using antibiotic, the days in ICU, the rats of nosocomial infections, mortality were measured during the study. Results The days of mainline insulin 10.0±2.8, the days of using antibiotic (14.5±3.4), the days in ICU (11.0±4.6), the rate of repeated infection (13.3%), mortality (16.5%) in the treatment group were decreased significantly than those in the control group ( P <0.05). Conclusion Intensive insulin therapy might improve the effect and decrease mortality of the critical illness patients when the blood glucose were kept high levels.