强化胰岛素治疗对多器官功能障碍综合征患者预后的影响

Effects of intensive insulin therapy on the prognosis of multiple organ dysfunction syndrome patients

目的观察强化胰岛素治疗对多器官功能障碍综合征（MODS）患者预后的影响。方法选择2005-07～2007-07我院ICU收治的MODS患者65例,随机分成强化胰岛素治疗组（n=31）、常规治疗组（n=34）。强化胰岛素治疗组入院后即给予微量泵泵推胰岛素控制血糖在4.0～6.1mmol/L,常规治疗组血糖控制在10.0～11.0mmol/L,观察两组患者住院病死率、院内感染发生率及机械通气时间。结果强化胰岛素治疗组患者住院病死率、院内感染发生率及机械通气时间均明显低于常规治疗组（P〈0.05）。结论强化胰岛素治疗MODS患者可明显减少并发症,降低病死率,改善预后。

Objective To observe the effects of intensive insulin treatment on the prognosis of multiple organ dysfunction syndrome （MODS） patients. Method From July 2005 to July 2007,65 patients with MODS from Department of Intensive Care Unit ,the Second Hospital of Jilin University were randomly divided into two groups：intensive insulin therapy group（ n = 31 ） and control group （ n = 34 ）. Inten- sive insulin treatment group received insulin by intravenous injection in order to maintain blood glucose levels at 4.0-6.1 mmol/L,while the control group received routine insulin treatment in order to maintain blood glucose levels at 10.0 - 11.0 mmol/L. The mortality in hospital,incidence of nosocomial infection and time of mechanical ventilation were observed in two groups. Results After the intensive insulin therapy, the mortality in hospital, incidence of nosocomial infection and time of mechanical ventilation were significantly lower than in control group（ P 〈 0.05 ）. The prognosis of MODS patients was significantly improved. Conclusions Intensive insulin therapy might reduce the complications and mortality, improve the prognosis in the patients of MODS.