肺癌合并2型糖尿病围手术期血糖管理

The Blood Glucose Management in Lung Cancer Complicated with type 2 Diabetes Mellitus During the Operation Period

目的探讨肺癌合并2型糖尿病患者术后不同血糖控制方案的疗效。方法选择61例肺癌合并2型糖尿病的患者,随机分为3组:静脉输注组、胰岛素泵组和甘精胰岛素组。于术后检测3组各项临床指标。结果治疗后甘精胰岛素组在血糖控制时间、治疗后日平均血糖、胰岛素日使用量、低血糖的发生率及血糖波动程度、胰岛素抵抗指数等方面与胰岛素泵组无差异,但均显著低于静脉胰岛素输注组。结论肺癌合并2型糖尿病患者在围术期采用甘精胰岛素和胰岛素泵治疗均可安全有效的控制血糖。

Objective To investigate the clinical efficacy of different blood glucose management in lung cancer with type 2 diabetes mellitus during the perioperative period.Methods 61 perioperative patients with type 2 diabetes and lung cancer were divided into three groups.One group received injection of glargine,another group received pump and basic dose of insulin,the third group received intravenous insulin infusion.Clinical indicators were compared among three groups after treatment.Results The blood glucose controlled time,the average blood glucose,insulin dosage per day,incidence of hypoglycemia homeostasis model assessment（HOMA） for insulin resistance and blood glucose fluctuations in the glargine group had no significant difference when compared with insulin pumps group,but were significant lower than those in the intravenous insulin infusion group.The average daily cost in glargine group was significantly lower than that in insulin pumps group.Conclusion The therapy of glargine and insulin pump can be safety control blood glucose and improve insulin resistance in type 2 diabetes with lung cancer during the perioperative period;where as glargine is more suitable for clinical application.