胰岛素不同给药方式控制危重症应激性高血糖的临床观察

Clinical observation of different administration of insulin to control critically ill patients with stress hyperglycemia

目的探讨胰岛素不同给药方式对危重症应激性高血糖控制的临床疗效。方法将重症监护室(ICU)住院治疗的危重症应激性高血糖患者100例随机分为2组。观察组52例行静脉泵连续皮下输注胰岛素控制血糖,对照组48例予胰岛素多次皮下注射治疗。比较2组血糖控制情况。结果观察组血糖达标时间为(2.3±0.8)d短于对照组的(4.8±1.4)d,差异有统计学意义(P<0.05)。观察组低血糖发生率为5.8%低于对照组的16.7%,差异有统计学意义(P<0.05)。2组治疗后空腹血糖比较差异无统计学意义(P>0.05)。结论微量泵控制血糖安全、稳定,疗效迅速,低血糖发生率低,适合不同个体的生理需要,是控制应激性高血糖较好的方法。

Objective To explore effect of the different methods of insulin delivery to control critically ill patients with stress hyperglycemia.Methods 100 cases of critically ill patients with stress hyperglycemia,ICU of our hospital inpatient treatment,were randomly divided into 2 groups.Observation group of 52 patients were given continuous subcutaneous pump infusion of intravenous insulin to control blood sugar,control group of 48 patients were given multiple subcutaneous insulin therapy.Compared glycemic control of two groups.Results The time for blood glucose of observation group was（2.3±0.8）shorter than（4.8±1.4）of control group,the difference was statistically significant（P〈0.05）.The hypoglycemia of observation group was 5.8% lower than 16.7% of control group,the difference was statistically significant（P〈0.05）.The difference of fasting blood glucose between two groups was not statistical significance（P〉0.05）.Conclusion The micro pump methods to control blood sugar safe,stable,rapid efficacy,low incidence of hypoglycemia for the physical needs of different individuals,is to control stress-induced high blood sugar more satisfactory way.