胰岛素泵在糖尿病酮症酸中毒治疗中的疗效观察

Observation of the curative effect of insulin infused with insulin pump in the treatment of diabetic ketoacidosis

目的:探讨胰岛素泵持续皮下输注胰岛素在治疗糖尿病酮症酸中毒中的疗效。方法:回顾性分析我院住院糖尿病酮症酸中毒患者50例,分为治疗组(30例)和对照组(20例),分别使用胰岛素泵皮下输注胰岛素和小剂量胰岛素静脉滴注,常规胰岛素的用量为0.1 IU/(kg.h),待血糖降至13.9 mmol/L时,对照组改为胰岛素多次皮下注射,治疗组则继续使用胰岛素泵。观察血糖、血酮体、尿酮体,以及胰岛素剂量、平均治愈时间、低血糖发生率等。结果:两组患者的血糖在治疗后均明显下降,差异无显著性。两组患者的酸中毒在治疗后均得到纠正,治疗组恢复正常(9.4±3.6)h短于对照组(15.7±6.2)h,两组差异有显著性(P<0.01)。治疗组治疗后尿酮体转阴为(6.0±2.30)h,对照组为(15.34±4.66)h,两组差异有极显著性(P<0.01)。结论:胰岛素泵模拟了胰岛素的生理分泌,治疗糖尿病酮症酸中毒可以取得比对照组更满意的疗效。

Objective：To evaluate the effect of insulin infused with insulin pump unremittingly in the treatment of diabetic ketoacidosis. Methods：50 cases of diabetic ketoacidosis in the hospital were randomly divided into insulin infused with insulin pump unremittingly group （30 cases） and low dose intravenous infusion insulin group （20 cases）,the dose of regular insulin was 0.10 IU/（kg.h）.When blood sugar descended below 13.9 mmol/L,the low dose intravenous infusion insulin group was changed to multiple subcutaneous insulin injection,but the insulin pump unremittingly group was infused with insulin pump continuously. The changes of blood sugar,urine acetone body, insulin dosage ,average cure time and incidence rate of low blood sugar were observed.Results：After treatment, blood sugar level of the two groups descended obviously,there was not significantly difference.The acidosis in both groups got rectification after treatment. The level of pH recovered to normal. The recovering time in treatment group （17.6±1.9） was shorter than that in control group （33.7±3.65）, and there was very significantly difference （P〈0.01）.The time of urine acetone body turning to negative in treatment group after treatment was （6.0±2.3） h and that in control group （15.3±4.6） h,and there was significantly difference （P〈0.01）.Conclusion：Intensive treatment using continuous insulin infused with insulin pump could imitate the secretion of physiological insulin , Insulin pump may get more satisfactory curative effect on diabetic ketoacidosis.