胰岛素泵用于糖尿病足患者血糖控制的临床观察

Diabetic foot treated with insulin pump:a clinical observation

目的:对比应用胰岛素泵与多次皮下注射胰岛素对糖尿病足患者的疗效及安全性。方法:糖尿病足患者126例,随机分为CSII组和MSII组,CSII组给予胰岛素泵持续皮下注射优泌林R加餐前大剂量;MSII组采用三餐前皮下注射优泌林R及睡前注射优泌林N。对比治疗1个月两组患者空腹血糖、餐后2 h血糖值、血糖达标时间、胰岛素用量、低血糖次数及糖尿病足治疗效果。结果:治疗1个月后,两种方法均可使血糖达标,CSII组血糖达标时间、胰岛素用量、低血糖发生次数与MSII组比较,差异有统计学意义;CSII组糖尿病足总有效率与MSII组比较差异有统计学意义。结论:应用胰岛素泵治疗糖尿病足患者,血糖控制更迅速、安全、稳定,且可迅速地促进创面愈合。

Objective： To compare the therapeutic efficacy and safety between continuous subcutaneous insulin infusion （CSII）, and multiple subcutaneous insulin injection（MSII） in treatment of patients with diabetic foot. Methods： A total of 126 patients with diabetic foot were randomly divided into the CSII group and MSII group. The short-acting human insulin （Humulin R） was subcutaneously infused using pump continuously and high-dose human insulin was given before meals in CSII group;human insulin was subeutaneously injected before three meals and isophane insulin（ Humulin N） was injected before sleep in the MSII group. The fasting plasma glucose, 2 hours＇ postprandial blood glucose, the duration of blood glucose control, insulin dosage, the frequency of hypoglycemia and the therapeutic efficacy of diabetic foot were compared between the two groups in the first month of treatment. Results：In the first month of therapy, both methods could control the blood sugar at the target level, but the duration of blood glycose control, insulin dosage, the frequency of hypoglycemia and the therapeutic efficacy of diabetic foot between CSII and MSII showed significant differences. Conclusion：The insulin pump infusion therapy of patients with diabetic foot is safe, quick and stable in controlling blood sugar, and can accelerate healing of wounds.