强化胰岛素治疗对急诊ICU患者病情及预后的影响

Effect of Intensive Insulin Treatment in Condition and Prognosis of Patients in Emergency ICU

目的探讨急诊ICU患者采用强化胰岛素治疗的临床效果及对患者预后的影响。方法选取我院ICU 2014年2月至2016年2月期间收治的高血糖危重患者60例,按入院先后将患者分为两组各30例。其中对照组采用常规胰岛素降糖治疗,观察组采用强化胰岛素治疗。观察两组患者的健康状况、治疗时间以及预后情况。结果治疗后,观察组的APACHE-Ⅱ评分显著低于对照组(P<0.05)。观察组的静滴胰岛素时间、抗生素使用时间以及住院时间均显著短于对照组(P<0.05)。观察组的低血糖发生率显著高于对照组,而院内感染率及死亡率显著低于对照组(P均<0.05)。结论强化胰岛素治疗可使ICU患者的血糖恢复至正常范围,缩短住院时间及抗生素使用时间,感染率下降,改善患者的预后,值得临床应用及推广。

Objective To explore the clinical effect of intensive insulin treatment for patients in emergency ICU and influence onprognosis of patients. Methods 60 cases of critical ill patients with high blood sugar admitted to ICU of our hospital from February 2014 toFebruary 2016 were selected and divided into two groups according to amission order, with 30 cases in each group. The control groupreceived conventional insulin glucose-lowering treatment, while the observation group received intensive insulin treatment. The health,treatment time and prognosis of patients in two groups were observed. Results After treatment, the APACHE- II score of observation groupwas significantly lower than that of control group （P 〈0.05）. The infusion time of insulin, use time of antibiotics and hospitalization time ofobservation group were significantly shorter than those of control group （P〈0.05）. The incidence of hypoglycemia of observation group wassignificantly higher than that of control group, and the nosocomial infection rate and mortality were significantly lower than those of controlgroup （all P 〈0.05）. Conclusions The intensive insulin treatment can help the blood sugar oflCU patients return to normal range, shorten thehospitalization time and use time of antibiotics, reduce the infection rate and improve the prognosis of patients, which is worthy of clinicalapplication and promotion.