实时动态血糖监测系统联合胰岛素泵治疗在胃转流手术围手术期的应用

Application of combination of the DGMS~ Real-Time monitering and CSII during perioperative period of gastric bypass operation

目的研究实时动态血糖监测系统(DGMSReal-Time)联合胰岛素泵(CSII)治疗在胃转流手术(GBP)围手术期的应用。方法将44例符合GBP条件的T2DM患者随机分为试验组和对照组,试验组20例采用DGMS?Real-Time联合CSII治疗,对照组24例采用指尖血糖监测联合胰岛素持续静脉滴注及皮下胰岛素注射治疗。连续观察整个围手术期血糖水平、全天胰岛素用量、低血糖发生率、高血糖发生率。结果 (1)试验组术前、术中及术后各时间点平均血糖均低于对照组,差异有统计学意义(P<0.05或P<0.01)。(2)试验组整个围手术期平均血糖、24h胰岛素用量均低于对照组,差异有统计学意义(P<0.05)。(3)试验组低血糖发生率、高血糖发生率均低于对照组,差异有统计学意义(P<0.05)。结论胃转流手术围手术期,DGMSReal-Time联合CSII治疗优于指尖血糖监测联合胰岛素持续静脉滴注及皮下胰岛素注射治疗。

Objective To study the application of combination of real-time dynamic glucose monitoring and continuous subcutaneous insulin infusion （CSII） during perioperative period of gastric bypass operation. Methods Forty-four T2DM patients undergoing GBP surgery were randomized into experimental group and control group. The experimental group, 20 cases, was treated with DGMS Real- Time monitering combining with CSII, while the control group, 24 cases, was treated with the fingertip blood glucose monitoring plus insulin infusion and subcutaneous insulin injection. The two groups were observed for the level of blood glucose, all-day insulin dosage, and incidence of hypoglycemia and hyperglycemia during peri-operative period. Results （1） At different time points of pre-, intra-, and post-operative period, the level of blood glucose in the experimental group was significantly lower than in the control group （P〈0. 05 or P〈0. 01）. （2）The level of average blood glucose and 24 h insulin dosage during peri-operative period in the experimental group were significantly lower than in the control group, （P〈0. 05）. （3）The incidence of hypoglycemia and hyperglycemia was lower in the experimental group than in the control group （P〈0.05）. Conclusion The treatment with DGMS Real-Time monitering and CSII has better therapeutic effects than the traditional fingertip blood glucose monitoring plus insulin infusion and subcutaneous insulin injection.