终末期糖尿病肾脏病腹膜透析时胰岛素用药途径的探讨

Exploration on the route of insulin administration in patients with end-stage diabetic nephropathy receiving peritoneal dialysis

目的比较终末期糖尿病肾脏病患者腹膜透析时不同途径给予胰岛素时腹膜炎的发生率。方法将50例行持续性非卧床腹膜透析（CAPD）的终末期糖尿病肾脏病患者随机分组，腹腔注射组25例，于腹腔内注射胰岛素；皮下注射组25例，于皮下注射胰岛素。比较2组透析前后收缩压、舒张压、尿量、超滤量及腹膜透析后腹膜炎发生率。结果2组透析前后收缩压、舒张压、尿量、超滤量均无统计学差异（P〉0．05）。腹腔注射组发生腹膜炎共11例次，发生率为1次／26．0个患者月；皮下注射组发生腹膜炎共13例次，发生率为1次／22．9个患者月。结论终末期糖尿病肾脏病患者行CAPD时，腹腔内注射胰岛素不会增加腹膜炎的发生率，对依从性好的患者是首选方法。

Objective To explore the route of insulin administration in patients with end-stage diabetic nephropathy receiving peritoneal dialysis. Methods Fifty patients with end-stage diabetic nephropathy receiving continuous ambulatory peritoneal dialysis （CAPD） were randomly divided into two groups., routine intra-abdominal injection group （n = 25）, routine subcutaneous injection group （n = 25）. Systolic blood pressure, diastolic blood pressure, urine volume, ultrafiltration volume,and the incidence of peritonitis before and after CAPD were compared between two groups. Results There was no significant difference in systolic blood pressure, diastolic blood pressure, urine volume,and ultrafil- tration volume before and after CAPD between two groups. The incidence of peritonitis in routine intra-abdominal injection group was 1/26. 0 patients months, and that in routine subcutaneous injection group was 1/22. 9 patients months. Conclusions When the patients with end-stage diabetic nephropa- thy accept CAPD, intra-abdominal insulin injections can not increase the incidence of peritonitis.