胰岛素泵治疗糖尿病酮症酸中毒的临床观察

Clinical Observation of Continuous Subcutaneous Insulin Infusion in Treatment of Diabetic Ketoacidosis

目的:比较胰岛素泵连续皮下输注(CSII)与静脉连续输注(CVII)治疗糖尿病酮症酸中毒的疗效。方法:30例糖尿病酮症酸中毒患者分为胰岛素泵连续皮下输注(CSII)组与静脉连续输注(CVII)组各15例。结果:两组治疗后血糖均明显下降,CSII组优于CVII组,差异有显著性(P<0.01);CSII组平均胰岛素用量为(0.67±0.14)U/(kg.d)明显少于CVII(0.82±0.16)U/(kg.d)(P<0.05);CSII组尿酮体转阴时间(17.5±7.4)h明显短于CVII组的(41.2±12.1)h(P<0.01);CSII组低血糖发生率(0.52±0.22)次/人,显著低于CVII组的(0.75±0.26)次/人(P<0.05)。结论:CSII能更快、更有效地控制糖尿病酮症酸中毒高血糖。

Objective: To compare the efficacy and safety of continuous insulin infusion (CSII) and continuous intravenous insulin infusion(CVII) with regular human insulin in patients with diabetic ketoacidosis(DKA). Method: 30 patients with DKA were randomized to receive either CSII by a portable insulin pump(n=15)or CVII(n=15). Results: CSII and CVII were both effective in controlling blood glucose levels. CSII therapy provided better glycenic control (P < 0.01). Mean insulin doses were significantly lower with CSII than with CVII [(0.67±0.14)U/(kg.d)(P<0.05)];The time to correct ketnuria was shorter in CSII group compared with CVII group(0.67±0.14)U/(kg.d) vs CVII(0.82±0.16)U/(kg.d)(P < 0.05); The rate of hypoglycemia was reduced in CSII group than in CVII group (0.52±0.22) vs (0.75±0.26)(P < 0.05). Conclusion: CSII can rapidly improve blood glucose in DKA.