精蛋白生物合成人胰岛素注射液联合胰岛素泵治疗糖尿病合并肺部感染的临床研究

Clinical Research on Novolin 30R and Insulin Pump Therapy for Diabetes Complicated by Pulmonary Infection

目的探讨精蛋白生物合成人胰岛素注射液(诺和灵30R)联合胰岛素泵治疗糖尿病合并肺部感染的临床效果。方法选取2010年1月至2013年2月乐山职业技术学院附属医院住院部收治的90例糖尿病合并肺部感染患者,采用随机数字表法分成对照组和观察组,各45例。对照组予以诺和灵30R治疗(每日在早餐前和睡前皮下注射)和常规治疗,观察组在对照组基础上加用胰岛素泵治疗,观察两组治疗后的临床效果。结果观察组总有效率显著高于对照组(100.0%比82.2%),两组疗效比较差异有统计学意义(P<0.05)。观察组患者在住院时间、血糖达标时间、体温恢复时间显著短于对照组[(8.6±2.5)d比(13.7±4.3)d,(4.7±1.1)d比(8.7±2.1)d,(4.3±1.0)d比(6.4±1.5)d,P<0.05]、胰岛素使用剂量、住院费用、并发症发生率显著低于对照组[(32±5)U/d比(47±8)U/d,(3037±367)元比(4974±672)元,4.4%比17.8%,P<0.05];观察组血钠、血钾、血浆胶体渗透浓度、尿素氮、血酮、p H值显著低于对照组[(132±7)mmol/L比(152±14)mmol/L,(4.1±0.4)mmol/L比(5.1±0.7)mmol/L,(312±16)mmol/L比(367±26)mmol/L,(10.6±2.4)mmol/L比(13.6±4.3)mmol/L,(4.2±1.5)mmol/L比(11.1±2.5)mmol/L,(7.12±0.13)比(7.64±0.46),均P<0.05]。结论诺和灵30R联合胰岛素泵治疗糖尿病合并肺部感染临床效果满意。

Objective To investigate the clinical effect of Novolin 30R and insulin pump therapy for diabetes complicated by pulmonary infection.Methods A total of 90 cases of diabetes complicated by pul-monary infection admitted in the Affiliated Hospital of Leshan Vocational and Technical College from Jan . 2010 to Feb.2013 were randomly divided into two groups,with 45 cases in each group.Patients in the control group received Novolin 30R treatment（subcutaneous injection before breakfast and bedtime every day） and conventional treatment,while patients in the observation group received insulin pump therapy on the basis of treatment in control group.Clinical effects of the two groups after treatment were observed.Results The total effective rate of observation group was higher than control group（100.0% vs 82.2%）,there was statistically significant difference of curative effect between the two groups（P〈0.05）.The duration of hospital stay,time of standard blood glucose,and body temperature recovery time of the observabion group were significantly shorter than those of the control group [（8.6 ±2.5） d vs （13.7 ±4.3） d,（4.7 ±1.1） d vs （8.7 ±2.1） d,（4.3 ± 1.0） d vs （6.4 ±1.5） d,P〈0.05],while the insulin doses,hospital costs,and complication rate of the ob-servabion group were significantly lower than those of the control group [（32 ±5） U/d vs （47 ±8） U/d, （3037 ±367） yuan vs （4974 ±672） yuan,4.4%vs 17.8%,P〈0.05],and levels of serum sodium,potas-sium,plasma colloidal osmotic concentration,urea nitrogen,blood ketone,PH of the observation group were significantly lower than those of the control group [（132 ±7） mmol/L vs （152 ±14） mmol/L,（4.1 ± 0.4） mmol/L vs （5.1 ±0.7） mmol/L,（312 ±16） mmol/L vs （367 ±26） mmol/L,（10.6 ±2.4） mmol/L vs （13.6 ±4.3） mmol/L,（4.2 ±1.5） mmol/L vs （11.1 ±2.5） mmol/L,（7.12 ±0.13） vs （7.64 ± 0.46）,P〈0.05].Conclusion Novolin 30R combined with insulin pump therapy has satisfactory clinical results in treating diabetes complicated by pulmonary infection .