胰岛素泵持续皮下输注胰岛素法在妊娠期糖尿病治疗中的应用价值

Clinical evaluation of continuous subcutaneous insulin infusion for patients with gestational diabetes mellitus

目的:比较分析胰岛素泵持续皮下输注胰岛素法与传统皮下注射胰岛素法在妊娠期糖尿病治疗中的疗效,评价胰岛素泵持续皮下输注胰岛素法的临床应用价值。方法:将60例妊娠期糖尿病患者随机分为两组:胰岛素泵组(CSII组)30例和皮下注射组(MDSI组)30例。胰岛素泵组通过胰岛素泵给予持续皮下输注胰岛素进行治疗,皮下注射组给予每日2次皮下注射治疗。治疗两周后,比较分析两组治疗前、后的血糖控制情况;比较两组治疗后妊娠并发症、胎儿患病率及产后低血糖发生次数、产后3年内糖尿病患病率。结果:两种方法均能有效控制血糖水平;与传统皮下注射胰岛素组比较,胰岛素泵持续皮下输注胰岛素组治疗后的妊娠并发症、胎儿患病率、产后低血糖发生及产后3年内糖尿病患病率明显下降(P<0.05)。结论:胰岛素泵持续皮下输注胰岛素法治疗妊娠期糖尿病能稳定、有效地控制血糖水平;显著降低母婴并发症、产后低血糖的发生率和产后3年内糖尿病患病率。避免多次皮下注射的痛苦以及心理压力,改善患者生活质量,提高患者依从性。

Objective：To explore the clinical efficacy of continuous subcutaneous insulin infusion treatment with insulin bump for patients with gestational diabetes mellitus（GDM）.Method：Sixty patients with gestational diabetes mellitus（GDM） were enrolled.GDM patients were randomly divided into continuous subcutaneous insulin infusion group（CSII group=30） and multiple daily subcutaneous injection group（MDSI group=30）.The time of blood glucose controlled and the total insulin dosage were recorded.All the 60cases were followed up for 3 years.Result：The incidence of hypoglycemic reaction in CSII group was lower than that in MDSI group（P0.05）.The incidence of hypoglycemia,Pregnancy complications,fetal morbidity,and prevalence of diabetes within three years was significantly lower than that of MDSI group（P0.05）.Conclusion：CSII with insulin pump can control blood glucose stably and efficiently,and decrease the incidence of hypoglycemia,delivery-related complications and the prevalence rate of diabetes after delivery within 3years ;CSII with insulin pump avoid frequent hypodermic injection and psychological pressure.So it can improve life quality of patients and improve compliance of patients.