短期胰岛素泵强化治疗在重症病毒性肺炎合并应激性高血糖治疗中的疗效观察

Efficacy of short-term intensive treatment with insulin pump in severe viral pneumonia complionted with stress hyperglycemia

目的 探讨短期胰岛素泵强化治疗在重症病毒性肺炎合并应激性高血糖中的临床疗效。方法 选择我科2018年9月~2021年9月期间收治的重症病毒性肺炎合并应激性高血糖患者53例作为研究对象,分为短期静脉胰岛素泵强化治疗组和短期皮下胰岛素泵对照组,观察两组血糖达标时间、低血糖发生率、低钾发生率、继发感染率、多脏器衰竭发生率、APACHEⅡ评分、机械通气时间、死亡率、住院时间等指标的变化。结果 治疗组和对照组均能有效降低血糖,与对照组相比,治疗组血糖达标时间更短(P<0.05),显著降低重症病毒性肺炎的APACHEⅡ评分(P<0.05)、多脏器衰竭发生率(P<0.05)、继发感染率(P<0.05)和总住院时间(P<0.05),而在机械通气时间、死亡率以及并发症发生率方面两组无明显差别(P>0.05)。结论 短期静脉胰岛素泵强化治疗方案可以快速平稳地控制应激性高血糖,改善患者APACHEⅡ评分,降低多脏器衰竭及继发感染发生率,降低总住院时间,且操作方便,临床上值得推荐。

Objective To investigate the clinical effect of short-term intensive insulin therapy on severe viral pneumonia complicated with stress hyperglycemia.Methods Fifty-three patients with severe viral pneumonia combined with stress hyperglycemia admitted to our department from September 2018 to September 2021 were selected as research objects and were randomly divided into a short-term intravenous insulin pump intensive treatment group and a short-term subcutaneous insulin pump control group.The blood glucose standard time, incidence of hypoglycemia, incidence of hypokalemia, secondary infection rate, the incidence of multiple organ failure, APACHEⅡ score, mechanical ventilation time, mortality, length of hospital stay, and other indexes were observed in the two groups.Results Both the treatment group and the control group could reduce blood glucose effectively. Compared with the control group, the blood glucose standard time in the treatment group was shorter(P<0.05), and the APACHEⅡ score of severe viral pneumonia(P<0.05), the incidence of multiple organ failure(P<0.05), the secondary infection rate(P<0.05) and the total length of hospital stay were significantly reduced(P<0.05). While there was no significant difference in terms of mechanical ventilation time, mortality, and complication rates between the two groups (P>0.05).Conclusion Short-term insulin-intensive treatment with a vein pump can control stress hyperglycemia rapidly and stably, reduce patients’ APACHEⅡ score, reduce the incidence of multiple organ failure and secondary infection, reduce the total length of hospital stay, convenient operation, and be worthy of clinical recommendation.