胰岛素泵在糖尿病酮症患者中的应用与护理

APPLICATION AND NURSING OF INSULIN PUMP TO DIABETES KETOSIS PATIENTS

目的观察胰岛素泵在糖尿病酮症患者中的应用。方法采用随机、对照的方法,将48例糖尿病酮症患者(无酸中毒和昏迷)分为治疗组[持续胰岛素皮下注射法(continuous subcutaneous insulin infusion,CSII)]和对照组[多次皮下注射胰岛素法(multiple daily insulin injection,MDII)]。观察2组患者晨尿酮体转阴时间、酮体转阴时胰岛素剂量及观察期间低血糖发生次数。结果 2组患者晨尿酮体转阴时间比较差异无统计学意义(P>0.05),但CSII组酮体转阴时所用胰岛素剂量与MDII相比较少,差异有统计学意义(P<0.05)。观察期间MDII组出现低血糖13例,CSII组4例,差异有统计学意义(P<0.05)。结论 CSII能较快、平稳降低血糖水平,促进酮体转阴,强化期间血糖波动较小,低血糖风险降低,患者依存性良好。而加强置泵过程护理、严密血糖监测、严格胰岛素泵管理是治疗糖尿病酮症的关键。

Objective To observe the clinical effect of insulin pump in diabetes ketosis patients. Methods A totle of 48 diabetes ketosis patients without acidosis and cataphora were randomly divided into therapy group （continuouse subcutaneous insulin infusion, CSII）and control group （multiple daily insulin injection, MDII）. For each patient, the turning negative time of urine, doses of insulin and the frequency of hypoglycaemia were assessed. Results There was not statistically significant difference in the turning negative time of urine between the two groups after treatment（ P 〉0.05 ）. But the doses of insulin for CSII group were less than MDII group,there was statistically significant difference between the two groups（P 〈 0.05 ）. There were 13 times of hypoglycaemia in MDIi group during the treatment. But only 4 times for CSII group. Conclusion CSII can promote turning negative of ketone by lowering blood sugar level fastly and placidly. Moreover the fluctuation of blood glucose was less, the risk of hypoglycaemia was lower and the compliance of patients was better than control group during treatment. But, it is very important to place the insulin pump seriously, monitor blood sugar rigorously and administer strictly for insulin pump treatment.