胰岛素在急诊治疗糖尿病酮症酸中毒患者治疗中的作用

The Role of Insulin in the Emergency Treatment of Patients with Diabetic Ketoacidosis

目的 探讨胰岛素在急诊治疗糖尿病酮症酸中毒患者治疗中的临床疗效及其安全性。方法 选取2019年1月-2022年12月在盱眙县人民医院进行相关治疗的60例糖尿病酮症酸中毒患者为研究对象。按照信封法进行随机等分处理,对照组予以常规急诊治疗,观察组予以胰岛素治疗。监测两组患者空腹血糖、餐后2 h血糖及糖化血红蛋白指标,同时记录血糖达标时间、尿酮转阴时间、并发症(昏迷、低血钾、低血糖)发生情况,对比分析临床治疗效果。结果 观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组空腹血糖、餐后2 h血糖以及糖化血红蛋白指标水平均较对照组更优,差异有统计学意义(P<0.05);观察组血糖达标时间和尿酮转阴时间均更短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率与对照组相比明显更低,差异有统计学意义(P<0.05)。结论 急诊治疗糖尿病酮症酸中毒患者期间,加入胰岛素治疗会明显提高治疗效果,改善机体血糖状态,缩短血糖达标与尿酮转阴时间,减少并发症发生风险,保证患者治疗成效。

Objective To investigate the clinical efficacy and safety of insulin in the emergency treatment of patients with diabetic ketoacidosis.Methods A total of 60 patients with diabetic ketoacidosis who received relevant treatment in Xuyi County People's Hospital from January 2019 to December 2022 were selected as the subjects of the study.The patients in the control group were given routine emergency treatment,and the observation group was given insulin therapy.The fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin indexes were monitored,at the same time,the time of blood glucose reaching the standard,the time of urine ketone turning negative,and the occurrence of complications(coma,hypokalemia,hypoglycemia)were recorded,and the clinical treatment effect was compared and analyzed in the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05);the levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).The time for blood glucose to reach the standard and the time for urine ketone to turn negative in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion During the emergency treatment of patients with diabetic ketoacidosis,adding insulin therapy will signifi‐cantly improve the therapeutic effect,improve the body's blood sugar status,shorten the time between blood sugar reaching the standard and urine ketone turning negative,reduce the risk of complications,and ensure the treatment effect of patients.