两种方法控制肝移植术后血糖升高效果比较

Effective comparison of two methods to control hyperglucose after liver transplantation

目的对比分析胰岛素泵和皮下注射胰岛素对患者血糖控制的效果。方法将2005—2012年以来肝移植术后血糖升高患者随机分为胰岛素泵治疗组(CSⅡ组)和多次皮下注射胰岛素组(MDI组),对两组患者的血糖控制情况、血糖达标时间、低血糖发生率、术后切口感染率、平均住院时间进行比较。结果两组患者血糖值均能达到目标值,CSⅡ组较MDI组血糖达标时间短、低血糖发生率低、切口感染率低、平均住院时间短[(5.2±1.5 vs.8.9±3.5)d、0.0%与4.8%、9.3%与14.3%、(21.3与29.5)d],差异均有统计学意义(P<0.01)。结论胰岛素泵较皮下注射胰岛素对肝移植术后血糖控制有明显优势。

Objective To analyze the effect of insulin pump and hypodermic injection insulin to control hyperglucose after liver transplantation.Methods 96 hyperglycemia patients after liver transplantation enrolled in hospital from 2005 to 2012 were randomly divided into insulin pump group（CSⅡgroup,n=54） and multiple subcutaneous insulin injection group（MDI group,n =42）,the control of blood glucose,duration of glycemic controlling,incidence of hypoglycemia,postoperative wound infection rate and average hospitalization days in the two groups were compared.Results Patients′ blood glucose in two groups could reach the target,while comparing with the MDI group,the CSⅡ group was with shorter time to reach the target of glucose,lower rates of hypoglycemia,lower infection rate and shorter average hospitalization,and the difference in the two groups had statisticall significance[（5.2±1.5 vs.8.9±3.5）d,0.0% vs.4.8%,9.3% vs.14.3%,21.3 vs.29.5 d,P0.01].Conclusion The subcutaneous injection of insulin has obvious advantage of controlling the blood glucose on patients after liver transplantation.