胰岛素泵对老年危重患者应激性高血糖的影响

Effect of insulin pump on elderly severe patients with stress hyperglycemia

目的观察胰岛素泵治疗对老年危重患者应激性高血糖的有效性及安全性。方法将86例老年危重病应激性高血糖患者随机分为治疗组43例（胰岛素泵治疗）和对照组43例（静滴胰岛素）,设定血糖控制目标为4.9∽6.1mmol/L。比较两组之间的血糖达标时间、胰岛素用量、入住重症医学科时间、低血糖发生率、多器官功能障碍综合征（MODS）发生率、病死率。结果治疗组患者血糖达标时间、入住重症医学科时间缩短,胰岛素平均日用量减少,低血糖发生率、MODS发生率、病死率降低,与对照组比较差异有显著性（P〈0.01）。结论早期胰岛素泵强化治疗老年危重病应激性高血糖,能更快、更平稳地控制血糖,能缩短住院天数,减少胰岛素平均日用量,降低低血糖发生率、MODS发生率、病死率,安全有效。

Objective To observe the effect of insulin pump treatment on the elderly critically ill patients with stress hy- perglycemia effectiveness and safety. Methods 86 cases of elderly critically ill patients with stress hyperglycemia were ran- domly divided into the treatment group of 43cases（insulin pump therapy） and control group（d3cases of intravenous insulin）, set the target of glycemic control is 4. 9 - 6. 1 mmol/L. The comparison between the two groups of time, dosage of insulin, blood glucose in intensive care medicine time, the incidence of hypoglycemia, multiple organ dysfunction syndrome （MODS） incidence rate,mortality rate. Results The patients in the treatment group, blood glucose time in intensive care medicine, shorten time, reduce the average daily insulin dosage, incidence of hypoglycemia, reduce the mortality rate, MODS, there is significant difference compared with the control group （ P 〈 0. 01 or P 〈 0. 05 ）. Conclusion Early intensive insulin pump treatment of elderly patients with critical illness hyperglycemia, faster, more smoothly to control blood sugar, can shorten the hospitalization time,reduce the average daily insulin dosage, reduce the incidence of hypoglycemia, MODS incidence rate, mortality rate, safe and effective.