胰岛素泵对2型糖尿病骨折患者围术期血糖水平达标情况的影响研究

Study on the Effect of Insulin Pump on the Perioperative Blood Glucose Level in Type 2 Diabetic Fracture Patients

目的探讨研究在2型糖尿病骨折患者的围术期治疗中,应用胰岛素泵进行血糖控制治疗,对患者血糖达标率情况的影响。方法选取2015年1月—2020年12月该院收治的80例2型糖尿病骨折患者为研究对象,将患者随机分为A、B、C、D 4组,均为20例。基础药物为利拉鲁肽,在此基础上A组行地特胰岛素泵治疗,B组行地特胰岛素治疗,C组行磺酰脲类治疗,D组行二甲双胍药物治疗,对比4组患者在给药后不同阶段的血糖水平,统计在围术期期间4组患者的血糖达标率,对比4组患者的治疗预后结局及患者治疗后生活质量。结果 A组、C组患者的血糖指标多是在5 d即可恢复正常,而B组、D组多是需要7 d或更久才可恢复正常,且C组患者在恢复正常后存在持续降低趋势,组间比较差异有统计学意义(P<0.05);A组患者的血糖控制治疗达标率95.00%显著高于B组80.00%、C组80.00%、D组85.00%,组间比较差异有统计学意义(P<0.05);A组患者的生理机能、生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能、精神健康8个维度的评分均显著高于B组、C组、D组,组间比较差异有统计学意义(P<0.05);A组患者的不良事件发生率15.00%显著低于B组35.00%,C组35.00%,D组30.00%,组间比较差异有统计学意义(P<0.05)。结论在糖尿病骨折患者的围术期血糖控制治疗中,采取胰岛素泵入治疗方案可以显著缩短血糖控制所需时间,提升控制稳定性,降低手术风险,提升患者预后结局。

Objective To investigate the effect of blood glucose control treatment with an insulin pump in the perioperative treatment of type 2 diabetic patients with fracture,on the patient’s blood glucose attainment rate.Methods 80 patients with type 2 diabetic fracture treated in the hospital from January 2015 to December 2020 were selected as the research object.The patients were randomly divided into 4 groups of A,B,C and D,all of which were 20 cases.The basic drug was liraglutide.On this basis,group A received insulin pump treatment,group B received insulin pump treatment,group C was treated with sulfonylurea,and group D was treated with metformin.The blood glucose levels of the four groups at different stages after administration were compared,the blood glucose compliance rate of the four groups during the perioperative period was counted,and the prognostic outcome and the quality of life of the 4 groups were compared.Results The blood glucose indicators of patients in group A and C returned to normal within 5 d,while in groups B and D,it took 7 d or more to return to normal,and patients in group C showed a continuous decreasing trend after returning to normal,the difference between the groups was statistically significant(P <0.05);the 95.00% of patients in group A had a significantly higher blood sugar control treatment compliance rate than 80.00% in group B,80.00% in group C,and 85.00% in group D,there was a significant difference between the groups(P<0.05);the scores of patients in group A on the eight dimensions of physiological function,physiological function,physical pain,health status,energy,social function,emotional function,and mental health were significantly higher than those of group B,group C,and group D,the difference between the groups was statistically significant(P<0.05);the adverse event rate of 15.00% in group A was significantly lower than 35.00% in group B,35.00% in group C,and 30.00% in group D,the difference between the groups was statistically significant(P <0.05).Conclusion In the treatment of diabetic fracture patients with perioperative glycemic control,the adoption of an insulin pump protocol can significantly reduce the time required for glycemic control,improve control stability,reduce surgical risk,and enhance patient outcomes.