胰岛素泵在新诊断T2DM合并骨折围手术期的应用

Application of insulin pump in perioperative period in new diagnosis of T2DM with fracture

目的比较胰岛素泵（CSII）与常规多次皮下注射胰岛素（MSII）在新诊断2型糖尿病（T2DM）患者中骨折围手术期的血糖控制时间、胰岛素每日用量、低血糖发生率。方法选取我院2013年3月～2014年2月骨科收治新诊断2型糖尿病合并骨折围手术期的患者，共30例。将其分为两组：治疗组16例，男9例，女7例，年龄24～77岁，平均53岁，给予CSII治疗；对照组14例，男6例，女8例，年龄34～76岁，平均48岁，给予常规MSII治疗。比较两组控制血糖时间、胰岛素每日用量、低血糖发生率等。结果与对照组比较，治疗组胰岛素每日用量明显减少（P〈0．01），控制血糖时间明显缩短（P〈0．01），而两组低血糖发生率无显著差异（P〉0．05）。结论与MSII比较，CSII能更好地控制骨折围手术期的血糖，治疗时间明显缩短，胰岛素每日用量明显减少，为手术争取了宝贵时间。

Objective To compare the blood glucose control time, daily dosage of insulin, and incidence of hypoglycemia in perioperative period of patients with newly diagnosed type 2 diabetes mellitus （T2DM） and fracture when insulin pump （CSII） and conventional multiple subcutaneous insulin injection （MSII） are applied. Methods Total 30 patients with newly admitted patients with T2DM with fracture in Department of Orthopedics of our hospital from Mar. 2013 to Feb. 2014 were selected as the research subjects （n = 30） and were randomly divided into two groups： treatment group （n = 16, including nine malesand seven females; aged 24-77, averagely 53, and CSII were applied）, and control group （n = 14, including 6 males and 8 females; aged 34-76, averagely 48, and conventional MSII were applied）. And then, the blood glucose control time, daily dosage of insulin, and incidence of hypoglycemia between the two groups were compared. Results Compared with that in the control group, the daily dosage of insulin in the treatment group was reduced obviously （P 〈 0. O1 ） and the blood glucose control time was shortened obviously （P 〈 0.01）, while the incidence of hypoglycemia between the two groups had no significant difference （P 〉0.05）. Conclusion Compared with MSII, CSII can better control the blood glucose in perioperative period of patients with fracture; with the treatment time shortened and daily dosage of insulin reduced obviously, it can save much time for the operation.