不同胰岛素用药方案治疗糖尿病酮症酸中毒的临床评价

Clinical Evaluation of Different Insulin Drug Regimens in Treatment of Patients with Diabetes Ketoacidosis

目的:探讨不同胰岛素用药方案治疗糖尿病酮症酸中毒患者的临床疗效和安全性。方法:将广东省云浮市新兴县人民医院内分泌科2017年6月到2019年5月诊治的糖尿病酮症酸中毒患者86例随机分为对照组和观察组各43例。两组均先给予常规胰岛素静脉滴注和补液至血酮转阴,之后对照组给予三短一长方案继续皮下给予胰岛素,观察组通过胰岛素泵持续皮下治疗,至血糖正常。比较两组患者从血酮转阴后到血糖回归稳定水平期间的胰岛素用量、治疗时间、低血糖发生率。结果:与对照组相比,观察组的血糖达标时间、总胰岛素用量均明显低于对照组,P均<0.05;观察组低血糖发生率略低于对照组,但无明显差异,P>0.05。结论:糖尿病酮症酸中毒患者在血酮转阴后采用胰岛素泵持续皮下治疗可缩短血糖达标时间,减少低血糖发生率。

Objective:To explore the clinical efficacy and safety of different insulin delivery strategies in patients with diabetic ketoacidosis.Methods:86 patients with diabetic ketoacidosis admitted to our hospital were randomly divided into control group and observation group from Jun 2017 to May 2019,and each group was 43 cases.Both groups were initially treated with continuous intravenous insulin infusion and fluid supplements till the normalization of blood ketone.The control group was then given multiple insulin injections,while the observation group received continuous subcutaneous treatment through insulin pumps until their blood sugar returned to normal range.The total insulin dosage,treatment time and incidence of hypoglycemia from the blood ketone corrected to the blood glucose returns to a stable level were compared between the two groups.Results:Compared with the control group,the time required for the blood glucose to reach the normal level and the insulin usage was significantly lower(both P<0.05).The hypoglycemia incidence in the observation group was slightly lower than that in the control group(P>0.05).Conclusion:For patients with diabetic ketoacidosis,continuous subcutaneous treatment using insulin pump has a better effect of blood glucose control than multiple injections,it can shorten the time of blood glucose normalization and reduce the hypoglycemia risk.