静脉及皮下连续输注式胰岛素泵治疗糖尿病的临床观察

A Clinical Investigation of Diabetic Treatment Using Portable Subcutaneous or Intravenous Insulin pump Infusion

目的：比较３种不同的胰岛素给药方法对临床高血糖治疗的效果。方法：１２例ＮＩＤＤＭ及１０例ＩＤＤＭ病人接受了观察。其中１０例行常规多次皮下注射胰岛素治疗，８例接受胰岛素泵连续皮下输注胰岛素治疗，４例行胰岛素泵连续静脉输注治疗。 ３组治疗的靶血糖值均在３餐前及睡前血糖为≥３．６ ｍｍｏｌ／Ｌ但≤７，２ ｍｍｏｌ／Ｌ，至少 ３天。结果：３组达到靶血糖值时胰岛素用量无显著性差异（均 Ｐ＞０．０５），但两泵组强化治疗平均治愈天数显著缩短，且血糖控制更优于常规组。但皮下泵连续注射组低血糖发生率略高于常规用药组。结论：胰岛素泵连续皮下或静脉输注胰岛素模拟了胰岛素的生理分泌模式，较常规皮下注射能更快更有效地控制高血糖，是目前常用的强化胰岛素治疗方法。

To compare the effects on clinical hyperglycemia by three different insulin delivery ways, 12 cases NIDDM and 10 cases of IDDM were studied. Methods: 10 cases of them were treated by multiple subcutaneous insulin injection(MSII group),8 cases were treated by continuous subcutaneous insulin injection using insulin pump(CSII group), and 4 cases using continuous intravenous inslin pump(CVII group). The target blood glucose(BG) levels for all of tham were premeal and prebed BG≥3.6 mmol/L and ≤7 .2 mmol/L for at least 3 days. Result: Insulin don in three groups had no sighficant differences(p >0. 05), but the therapeutic duration in CSII and CVII was much shorter than that in MSII. Their average BG levels were more favourable than in MSII, but the hypoglycemia prevalence in CSII was higher than in MSII group. Conclusion: Insulin pump mimicked the physiological insulin secretion in CSII and CVII group. This delivery way for insulin was much faster and more effective to control clinical hyperglycemia.