胰岛素泵强化治疗糖尿病酮症酸中毒的疗效观察

Observation on Efficacy of Insulin Pump in Intensive Treatment of Diabetic Ketoacidosis

目的:探讨胰岛素泵强化治疗糖尿病酮症酸中毒的临床疗效。方法:选取2011年1月—2017年1月收治的糖尿病酮症酸中毒患者120例,以随机数字表法分为观察组与对照组,每组60例。两组患者均给予常规对症治疗,在此基础上,观察组患者采用胰岛素泵给予门冬胰岛素,对照组患者采用门冬胰岛素静脉注射。比较两组患者治疗前后空腹血糖(FPG)、二氧化碳结合力(CO2CP)水平,临床疗效,实验室检查指标恢复正常时间及不良反应发生情况。结果:治疗后,两组患者FPG、CO_2CP水平均较治疗前明显改善,差异有统计学意义(P<0.05),但两组的差异无统计学意义(P>0.05)。观察组患者的总有效率(96.67%,58/60)明显高于对照组(81.67%,49/60),血糖、pH、尿酮体及血酮体水平恢复正常时间明显短于对照组,胰岛素用量明显低于对照组,上述差异均有统计学意义(P<0.05)。两组患者不良反应发生率均较低,且差异无统计学意义(P>0.05)。结论:胰岛素泵强化治疗糖尿病酮症酸中毒的效果显著,患者恢复快,不良反应少。

OBJECTIVE： To probe into the clinical efficacy of insulin pump in intensive treatment of diabetic ketoacidosis. METHODS： 120 patients with diabetic ketoacidosis admitted into Qianjiang Central Hospital from Jan. 2011 to Jan. 2017 were selected and divided into observation group and control group via random number table, with 60 cases in each group. Both groups were given conventional symptomatic treatment, on this basis, the observation group was treated with insulin aspart pump, while the control group was given insulin aspart for intravenous injection. The fasting plasma glucose （FPG）, carbon dioxide combining power （CO2CP） levels, clinical efficacy, recovery times of laboratory indices and incidences of adverse drug reactions of two groups before and after treatment were compared. RESULTS： After treatment, levels of FPG and CO2CP of both groups were significantly improved than those of before treatment, with statistically significance difference （P 〈 0. 05）, while no statistical significance was found in differences between two groups （ P 〉 0. 05 ）. The total effective rate of observation group （96.67%, 58/60 ） was significantly higher than that of the control group （81.67%, 49/60）, the recovery times of plasma glucose, pH, urine ketone and blood ketone levels of observation group were significantly shorter than those of the control group, the dosage of insulin of observation group was significantly less than that of the control group, with statistically significance differences （P 〈 0. 05 ）. The incidences of adverse drug reactions of both groups were in a low level, and the difference had no statistical significance （P 〉 0. 05 ）. CONCLUSIONS： The efficacy insulin pump in intensive treatment of diabetic ketoacidosis is remarkable, with rapid recovery and few adverse drug reactions.