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危重病患者的加强胰岛素治疗 被引量:12

Study on intensive insulin therapy in critically ill patients
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摘要 目的观察危重病人加强胰岛素治疗后的的疗效。方法将116例危重病人随机分为两组,传统治疗组(CT)和加强胰岛素治疗组(IT)。CT组:当血糖>215mg/dl,诺和R笔芯皮下注射,控制血糖180~200mg/dl;IT组:当血糖>110mg/dl,控制血糖80~110mg/dl。结果CT组死亡率44.83%远远高于IT组的12.07%,病人的ICU住院时间、使用呼吸机日数、每日6:00的平均血糖、每日TISS-28评分均明显高于IT组(P<0.05);CT组每日胰岛素用量、HLA-DR、CD4+/CD8+明显小于IT组(P<0.05)。两组并发症比较,CT组病人发生肾损害、输注红细胞、发热的人数均明显高于IT组(P<0.05)。结论加强胰岛素治疗控制危重病人血糖80~110mg/dl,能降低病人的死亡率。 Objective To observe effects of intensive insulin therapy in critically ill patients .Methods A total of 116 critically ill patients were involoed in this study,all critically ill patients were randomly divided into two groups:intensive insulin therapy group(IT),conventional treatment groups(CT).IT were treated with intensive insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg per deciliter),CT were treated with infusion of insulin only if the blood glucose level exceeded 215 mg per deciliter (maintenance of glucose at a level between 180 and 200 mg per deciliter). Results At 24 months, reduced mortality (44.83 percent with conventional treatment, as compared with 12.07 percent with intensive insulin therapy),and reduced days of stay ICU,TISS-28 score perday,infection of fever,acute renal failure, red-cell transfusions, and patients receiving intensive insulin therapy were less likely to require prolonged mechanical ventilation and intensive care. and intensive insulin therapy raised HLA-DR、CD4+/CD8+obviously.Conclusion Intensive insulin therapy maintain blood glucose 80~110 mg per deciliter reduces morbidity and mortality of critically ill patients
出处 《江西医药》 CAS 2005年第6期315-318,共4页 Jiangxi Medical Journal
基金 浙江省教育厅资助课研项目(编号20030930)
关键词 危重病 ICU 高血糖 加强胰岛素治疗 critically ill patients ICU hyperglycemia intensive insulin therapy
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