胰岛素强化治疗对机械通气合并高血糖患者预后的影响

目的观察胰岛素强化治疗对机械通气合并高血糖患者预后的影响。方法对102例机械通气合并高血糖患者进行前瞻性随机对照研究，分成常规治疗组（CT组）和胰岛素强化治疗组（IT组），分别统计两组的呼吸机使用时间、呼吸机相关肺炎（VAP）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组的呼吸机使用时间、VAP发生率、MODS发生率及病死率比较，差异有统计学意义（P〈0．05）。结论胰岛素强化治疗控制血糖水平在4．4～6．1mmol／L，对缩短机械通气合并高血糖患者使用呼吸机时间、减少呼吸机相关肺炎发生、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 prognostic of mechanical ventilation combined withhyperglychemi. Methods Based on a prospective random contrasted clinical research, 102 patients with mechanical ventilation combined with hyperglyehemi were divided into two groups, one group was conventional treatment and the other was intensive insulin therapy. The time of mechanic ventilation, the rate of Pneumonia caused by mechanical ventilation, the rate of the multiple organ dysfunction syndrome （MODS） and the mortality rate were observed. Results The time of mechanical ventilation, the rate of VAP, the rate of MODS and the mortality rate of two groups were significantly different （ P 〈 0. 05 ）. Conclusion Intensive insulin therapy maintaining blood glucose at the level 4.4 - 6. 1 mmol/L has positive significance on shorting the time of mechanical ventilation, reducing the rate of pneumonia caused by mechanical ventilation, ruducing the mortality rate, and improving the prognosis of the patients.