胰岛素泵在并发2型糖尿病的冠状动脉旁路成形术患者围手术期的应用

Clinical Observation of Type 2 Diabetic Patients with Insulin Pump Usage during Perioperative Period of Coronary Artery Bypass Grafting

目的观察并发2型糖尿病(T2DM)的冠状动脉旁路成形术患者围手术期胰岛素泵的操作、临床疗效和安全性。方法将拟行冠状动脉旁路成形术手术的T2DM患者分为胰岛素泵持续皮下注射组(CSII组)23例,多次皮下胰岛素组(MSII组)21例。观察两组患者手术前后的血糖、血脂变化、切口的感染率和总住院天数。结果 CSII组和MSII组血糖达标时间分别为(3.22±1.31),(7.00±4.07)d,发生低血糖分别有1和3例(P<0.05),胰岛素的用量分别为(40.82±16.79)和(40±15.23)U.d-1,总住院时间分别为(22.86±12.76)和(29.18±20.94)d(P>0.05),切口感染均有1例。结论采用CSII法能更快、更好地控制并发T2DM的冠状动脉成形术患者血糖。

Objective To observe operation, clinical efficacy and safety of insulin pump in patients with type 2 diabetes mellitus （T2DM） during perioperative period of coronary artery bypass grafting. Methods The patients were assigned into two groups ： CSII group （ n = 23 ） , treated with continuously hypodermic injection by insulin pump ; MSII group （ n = 21 ）, treated with multiple injection of insulin. Blood glucose and lipid levels before and after the surgery, infection rate of incision and total hospitalized days were observed. Results Blood glucose time in CSII group and MSII group was （3.22± 1.31 ） and （7.00±4.07） days, respectively. One case in CSII group and 3 cases＇in MSII group developed hypoglycemia, with statistically significant difference （P〈0.05）. The doses of insulin in CSII group and MSII group were （40.82±16.79） and （40.00±15.23） U. d-1. Total hospitalized days for CSII group and MSII group were （22.86±12.76） and （29.18±20.94） days, respectively. There was one case of incision infection in each group. Conclusion By using CSII method, blood glucose can be controlled faster and better.