胰岛素强化治疗对呼吸机相关性肺炎并高血糖患者预后的影响

EFFECTS OF INTENSIVE INSULIN THERAPY ON THE PROGNOSIS OF THE PATIENTS WITH VENTILATOR-ASSOCIATED PNEUMONIA AND HYPERGLYCEMIA

目的:观察胰岛素强化治疗对呼吸机相关性肺炎(VAP)并高血糖患者预后的影响。方法:对108例VAP合并高血糖患者进行前瞻性随机对照研究,分成传统治疗组(CT组)和胰岛素强化治疗组(IT组),分别统计两组使用呼吸机时间、低血糖发生率、多器官功能障碍综合征(MODS)发生率及病死率。结果:CT组及IT组的使用呼吸机时间、MODS的发生率及病死率比较均有显著差异(P<0.05),低血糖发生率比较无显著差异(P(0.05)。结论:胰岛素强化治疗控制血糖水平在4.4～6.1mmol/L对缩短VAP患者使用呼吸机时间、降低病死率、改善预后具有积极意义。

Objective：To study the effects of intensive insulin therapy on the prognosis of the patients with ventilator-associated pneumonia（VAP）and hyperglycemia.Methods：Based on a prospective random-contrasted clinical research,108 patients with VAP and hyperglycemia were divided into intensive insulin therapy group and conventional treatment group.The time of mechanic ventilation 、the rate of hypoglycemia 、the rate of the multiple organ dysfunction syndrome（MODS） and the mortality rate were observed.Results：The time of mechanic ventilation、 the rate of MODS and the mortality rate of the two groups were significantly different（P〈0.05）.There was no difference in the rate of hypoglycemia of the two groups（P〉0.05）.Conclusion：Intensive insulin therapy maintaining blood glucose at a level 4.4-6.1mmol/L has positive significance on shorting the time of mechanic ventilation、reducing the mortality rate and improving the prognosis of the patients with VAP and hyperglycemia.