光子治疗对胰岛素注射相关性皮下脂肪增生的影响

Effects of photon therapy on insulin injection-related subcutaneous lipohypertrophy

目的探讨光子治疗对胰岛素注射相关性皮下脂肪增生(LH)的影响。方法选取2021年4月至2022年2月于南京医科大学第一附属医院内分泌科住院的99例糖尿病并伴有LH的患者作为研究对象。测量所有患者LH长径、宽径和深径并收集其最大LH、总LH和平均LH的长、宽及深径。借助SPSS 26.0软件生成随机数字并将研究对象分为试验组(50例)和对照组(49例)。对照组接受常规护理并避免在LH部位注射胰岛素,试验组在对照组措施的基础上开展光子治疗,每日2次,每个LH部位每次治疗20 min。采用两独立样本t检验、Mann-Whitney U检验、配对样本t检验、Wilcoxon符号秩和检验比较干预前后两组患者最大LH、总LH和平均LH的长、宽及深径的组间和组内差异。结果试验组与对照组分别有3例和2例患者失访,最终2组均纳入47例患者。在试验组和对照组,干预后最大LH、总LH和平均LH的长径、深径及宽径较干预前均更小(均P<0.05)。干预后,试验组最大LH和平均LH深径较对照组均更小(均P<0.05)。与对照组相比,试验组干预前后最大LH长径、最大LH宽径、总LH长径、总LH深径、总LH宽径、平均LH长径、平均LH深径、平均LH宽径的变化百分比均更大(均P<0.05)。结论住院期间,避免在糖尿病患者LH部位继续注射胰岛素有利于LH消退,在此基础上实施光子治疗可进一步缩小LH。

Objective To investigate the impact of phototherapy on lipohypertrophy(LH)induced by insulin injections.Methods Ninety-nine diabetes patients with LH who were admitted to the Endocrinology Department of the First Affiliated Hospital of Nanjing Medical University between April 2021 and February 2022 were selected as the study subjects.The length,width,and depth of each LH were measured,and the maximum LH,total LH,and average LH of the long,wide,and deep diameters were collected for all patients.SPSS 26.0 software was used to randomly allocate the subjects to the experimental group(50 cases)and the control group(49 cases).The control group received routine nursing care and avoided insulin injections at the LH site,while the experimental group received phototherapy based on the control group measures,twice a day,for 20 minutes each time for each LH site.Two independent sample t-tests,Mann-Whitney U tests,paired t-tests,and Wilcoxon signed-rank tests were used to compare the intergroup and intragroup differences in the length,depth,and width of the maximal LH,total LH,and average LH in the two groups before and after intervention.Results There were 3 patients lost to follow-up in the experimental group and 2 patients in the control group,respectively,and 47 patients were included in both groups.After intervention,the length,depth,and width of the maximum LH,total LH,and average LH were all smaller in both the experimental and control groups than before intervention(all P<0.05).After intervention,the depth of the maximum LH and average LH were smaller in the experimental group than in the control group(both P<0.05).Compared with the control group,the percentage changes in the length and depth of the maximum LH,the length,depth,and width of total LH,and the length,depth,and width of average LH before and after intervention were greater in the experimental group(all P<0.05).Conclusions Avoiding insulin injections at the LH site during hospitalization is beneficial for the regression of LH in diabetes patients.Phototherapy can further reduce LH by stopping insulin injection at the LH site.