微量泵在糖尿病酮症酸中毒治疗的应用

Treating patients with diabetic ketoacidosis by micro-perfusion pump

目的探讨应用微量泵治疗糖尿病酮症酸中毒的临床疗效。方法 2009年1月至2012年6月收治糖尿病酮症酸中毒患者60例,随机分为观察组及对照组,每组30例。观察组用微量泵治疗,微量泵以普通胰岛素0.1 U/(kg.h)持续静脉输注,依据每小时监测血糖调整输注速度,控制血糖在10 mmol/L左右;正常进食后停用微量泵,改用三餐前使用普通胰岛素和睡前使用中效胰岛素。对照组使用胰岛素泵加常规小剂量胰岛素静脉输注,未正常进食前胰岛素泵使用基础量,正常进食后停用胰岛素泵,改用三餐前使用普通胰岛素和睡前使用中效胰岛素。两组均常规补液消酮治疗。结果观察组与对照组血酮转阴时间、血糖达标时间、住院时间、低血糖发生率比较差异均无统计学意义(P>0.05)。结论微量泵与胰岛素泵在治疗糖尿病酮症酸中毒中疗效相当,值得在糖尿病酮症酸中毒治疗中推荐应用,特别是在无胰岛素泵的基层医院中使用。

Objective To investigate the clinical effect of diabetic ketoacidosis by micro-perfusion pump.Methods Sixty patients with diabetes ketoacidosis collected from January 2010 to June 2011 were randomly divided into observation group（30 cases）and control group（30 cases）.For observation group,micro-perfusion pump was used,seting up the micro-perfusion pump by 0.1 U/（kg· h）of ordinary insulin for continue intravenous infusion,adjusting the infusion speed based on the blood glucose levels monitored each hour,controlling the blood glucose levels at about 10 mmol/L.Stop using micro-perfusion pump when the eating recover,hypodermically the ordinary insulin before three meals and insulin NPH before going to bed.For control group,insulin pump was usesd,combined with ordinary insulin,by 0.1 U/（kg· h） for continue intravenous infusion,seting up the insulin pump by basic quantity before regular diet.After regular diet,stopping using insulin pump,hypodermically the ordinary insulin before three meals and insulin NPH before going to bed.Results Compared with control group,the test index in observation group showed no significant differences（P0.05）at some aspects including the time for blood ketone decreasing,blood glucose reaching standard level,length of stay and incidence of hypoglycemia.Conclusion The effect of using micro-perfusion pump is significant in treating diabetes ketoacidosis,the same as with insulin pump,which is worthy of recommendation,especially in the primary hospital.