胰岛素泵治疗糖尿病酮症酸中毒的疗效观察

THE CURATIVE EFFECT OF INSULIN PUMP IN THE TREATMENT OF DIABETIC KETOACIDOSIS

目的观察胰岛素泵持续皮下注射胰岛素(continuous subcutaneous insulin infusion,CSII)治疗糖尿病酮症酸中毒的疗效。方法 40例2型糖尿病酮症酸中毒患者随机分为胰岛素泵持续皮下注射组(CSII组,20例)和常规小剂量胰岛素静脉滴注组(对照组,20例),比较2组治疗效果。结果①CSII组血糖达标时间、尿酮体转阴时间及pH值恢复时间较对照组明显缩短(P<0.01);②CSII组胰岛素总用量明显少于对照组(P<0.05);③CSII组低血糖发生率明显低于对照组(P<0.01)。结论胰岛素泵能模拟人生理胰岛素分泌,是一种更安全、更快、更有效、更方便的糖尿病酮症酸中毒治疗方法 。

Objective To evaluate the efficacy and safety of continuous subcutaneous insulin infusion （CSII） in patients with diabetic ketoacidosis （DKA）. Methods Patients with DKA （ n = 40 ） were chosen for comparing the effect between CSII therapy （ CSII group, n = 20） and intravenous insulin instilling treament （ control group, n = 20）. The treatment effect was compared in the 2 group. Results （1） Both CSII and insulin instilling controlled DKA effectively, but the time to correct ketonuria and PH recovery time was shorter in CSII group compared with insulin intravenous instilling group（ P 〈 0.01 ）. （2） The total insulin dose was significantly lower with CSII than with insulin veuous instilling group （ 0. 01 ）. （3）The rates of glucopenia was lower in Conclusion Mimicking physiological secretion eonvinient method for DKA treatment. CSII group than in the control group （P 〈 0. 0 of insulin, CSII could be a safer, more efficient P〈 1）. andconvinient method for DKA treatment.