胰岛素不同给药方式对妊娠期糖尿病患者围手术期血糖控制的效果研究

Research on the Insulin in Different Modes of Administration on the Perioperative Blood Glucose Control of Gestational Diabetes

目的:研究胰岛素不同给药方式对妊娠期糖尿病患者围手术期血糖控制的效果与安全性。方法:选择2013年11月~2016年11月于我院接受治疗的92例妊娠期糖尿病患者,所有患者按随机数字表法分为对照组和研究组,每组46例。对照组围手术期予以皮下注射胰岛素治疗,研究组围手术期予以胰岛素泵治疗。比较两组空腹血糖(FBG),餐后2 h血糖(2hPBG),血糖达标情况,抗生素使用情况,切口愈合情况、住院时间及并发症的发生情况。结果:治疗后12 h、24 h及36 h,两组FBG、2hPBG水平均较治疗前显著下降,且研究组以上指标均低于对照组(P<0.05)。研究组血糖达标、抗生素使用、切口愈合及住院时间均明显短于对照组(P<0.05)。两组均有低血糖、切口感染发生,研究组并发症发生率低于对照组(P<0.05)。结论:胰岛素泵输注胰岛素对妊娠期糖尿病患者围手术血糖的控制效果明显优于皮下注射胰岛素,且其安全性更高。

Objective: To research the effect and safety of different insulin administration methods on the perioperative blood glucose control in patients with gestational diabetes mellitus. Methods: 92 cases of patients with gestational diabetes who were treated from November 2013 to November 2016 in our hospital were selected and divided into the control group and the research group according to the random number table, with 46 patients in each group. The control group was treated with subcutaneous injection of insulin during perioperative period, and the research group was treated with insulin pump during perioperative period. Then the fasting blood glucose(FBG), 2 h postprandial blood glucose(2 hPBG), blood glucose compliance, antibiotic use, incision healing, length of hospital stay, and incidence of complications were compared between the two groups. Results: At 12 h, 24 h and 36 h after treatment, the levels of FBG and2 h PBG in both groups were significantly lower than those before treatment, and the above indicators in the research group were lower than those in the control group(P<0.05). The blood glucose, antibiotic use, incision healing and hospitalization time in the research group were significantly shorter than those in the control group(P<0.05). The inceidence of hypoglycemia and incision infection in the research group was lower than that in the control group(P<0.05). Conclusion: Insulin pump infusion is significantly better than that of subcutaneous insulin injection on the perioperative blood glucose control in patients with gestational diabetes, with higher safety.