持续皮下胰岛素输注与每日多次皮下胰岛素注射在围手术期2型糖尿病患者中的临床观察

Clinical observation of continuing subcutaneous insulin infusion and multiple subcutaneous insulin injection on treating perioperative patients with Type 2 Diabetes

目的比较持续皮下胰岛素输注(CSII)与每日多次皮下胰岛素注射(MSII)在围手术期2型糖尿病患者使用中的疗效。方法将因其他疾病需进行外科手术治疗的2型糖尿病患者137例随机分为CSII组(70例)和MSII组(67例)。比较两组术前及术后48h血糖变化、术前血糖控制时间、低血糖发生率、住院天数、住院总费用的差异。结果两组治疗后血糖均显著下降,达到目标血糖值;CSII组与MSII组在术前血糖控制时间[(1.9±0.9)d、(3.5±1.2)d,P=0.00)[、低血糖发生率(0.36%、6.5%,P=0.00)、平均住院天数[(14.1±1.9)d、(19.5±2.2)d,P=0.00)]及住院总费用[(11588±42.1)元、(19568±58.7)元,P=0.00)[,两组比较均有统计学差异(P<0.05)。结论对于围手术期2型糖尿病患者,CSII在术前达标时间、低血糖发生率、住院天数和住院总费用方面均优于每日多次胰岛素皮下注射。

Objective To compare the effects of continuing subcutaneous insulin infusion （CSⅡ） and multiple subcutaneous insulin injection （MSII） on treating perioperative patients with type 2 diabetes mellitus （T2DM）. Methods 137 patients with T2DM who were ready for a surgeon were divided randomly into CSII group （n=70） and MSII group （n=67）. Preoperative and postoperative blood glucose within 48h,the target time before surgeon,incidence of hypoglycemia,hospital stay and total costs were compared. Results The blood glucose levels of two groups were significantly decreased to target after CSⅡ or MSⅡ. Compared with MSⅡ group, the preoperative target time （1.9±0.9day, 3.5 ± 1.2day, P=0.00）, the incidence of hypoglycemia（0.36%, 6.5%, P=0.00）, hospital stay （ 14.1 ±1.9day, 19.5±2.2day,P=0.00） and total costs （11588±42. lyuan, 19568±58.7yuan,P=0.00）,in CSⅡ group were significantly induced （P〈0.05）. Conclusion With shorter preoperative target time,lower incidence of hypoglycemia,hospital stay and total costs, CSⅡ treatment was prior to MSII in those perioperative patients with type 2 diabetes.