不同胰岛素给药方式治疗急诊糖尿病酮症酸中毒的临床分析

Clinical Analysis of Different Insulin Administration Modes in the Treat⁃ment of Emergency Diabetic Ketoacidosis

目的 探究急诊接收的糖尿病酮症酸中毒患者接受不同胰岛素给药方式对血糖水平、临床指标以及低血糖发生情况的影响。方法 选取2022年10月—2023年9月泉州市光前医院急诊科接诊的106例糖尿病酮症酸中毒患者作为研究对象。根据简化随机法分为对照组和研究组,每组53例。对照组采用小剂量胰岛素持续静脉滴注治疗,研究组接受胰岛素泵皮下输注治疗。对比两组患者血糖水平、临床指标,其中血糖指标包括空腹血糖(Fasting Plasma Glucose, FPG)、餐后2 h血糖(2 Hour Postprandial Plasma Glucose, 2 hPG)、糖化血红蛋白(Glycated Hemoglobin, HbA1c)。结果 治疗后,研究组FPG、2 hPG、HbAlc指标水平均低于对照组,差异有统计学意义(P均<0.05)。研究组尿酮体恢复时间、血酮体恢复时间、血糖达标时间、pH值恢复时间比对照组短,差异有统计学意义(P均<0.05),研究组胰岛素用量比对照组少,差异有统计学意义(P<0.05)。结论胰岛素泵皮下输注治疗对于急诊糖尿病酮症酸中毒患者具有显著疗效,可以有效改善患者的血糖水平,缩短尿酮体和血酮体的恢复时间,同时加速血糖达标和pH值恢复。此外,胰岛素泵治疗还可以减少胰岛素的用量。

Objective To explore the effects of different insulin administration methods on blood glucose level,clini-cal indexes and hypoglycemia in patients with diabetic ketoacidosis admitted to emergency department.Methods A to-tal of 106 diabetic ketoacidosis patients from the emergency department of Guangqian Hospital of Quanzhou city from October 2022 to September 2023 were selected as the study objects.The patients were divided into control group and study group according to simplified randomization method,with 53 cases in each group.The control group received continuous intravenous infusion of low-dose insulin,and the study group received subcutaneous infusion of insulin pump.The blood glucose levels and clinical indicators of the two groups were compared,and the blood glucose levels included fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG)and glycosylated hemoglobin(HbAlc).Results After treatment,the levels of FPG,2 hPG and HbAlc in the study group were lower than those in the control group,the differences were statistically significant(all P<0.05).Urine ketone body recovery time,blood ketone body recovery time,blood glucose compliance time,pH value recovery time of the study group were shorter than those of the control group,the differences were statistically significant(all P<0.05),and the insulin dosage of the study group was less than that of the control group,the difference was statistically significant(P<0.05).Conclusion Insulin pump subcutaneous infusion is effective for patients with emergency diabetic ketoacidosis,and it can effectively im-prove the blood glucose level of patients,shorten the recovery time of urine ketone bodies and blood ketone bodies,and accelerate blood glucose compliance and pH recovery.In addition,insulin pump treatment can also reduce the amount of insulin.