浅谈胰岛素泵在糖尿病患者口腔颌面外科围术期中的作用

Role of Insulin Pump in Perioperative Oral and Maxillofacial Surgery of Diabetic Patients

目的探讨胰岛素泵在糖尿病患者口腔颌面外科围术期中的作用。方法回顾性选取2022年1—12月潍坊内分泌与代谢病医院口腔科收治的60例糖尿病且接受口腔颌面外科手术患者的临床资料,将30例采用皮下注射胰岛素治疗的患者作为对照组,将30例采用胰岛素泵持续注射胰岛素治疗的患者为观察组。比较两组患者的胰岛β功能指标、血糖控制效果、围术期并发症发生率。结果两组患者术前的胰岛β功能指标比较,差异无统计学意义(P均>0.05)。术后复查时,观察组患者的各项胰岛β功能指标均优于对照组,差异有统计学意义(P均<0.05)。观察组血糖指标和糖化血红蛋白水平低于对照组,差异有统计学意义(P均<0.05)。观察组围术期并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论糖尿病合并口腔颌面外科手术的患者出现创口感染及并发症发生率较高,主要因素包括采取麻醉后产生的不良反应及手术创伤。为稳定控制血糖,应采取胰岛素泵持续皮下注射的方式,降低术后并发症风险,为患者的健康预后奠定基础。

Objective To discuss the effect of insulin pump in oral and maxillofacial surgery of diabetic patients dur-ing perioperative period.Methods The clinical data of 60 patients with diabetes who received oral and maxillofacial surgery in the Department of Stomatology of Weifang Endocrinology and Metabolic Disease Hospital from January to December 2022 were retrospectively selected.30 patients receiving subcutaneous insulin injection were selected as control group,and 50 patients receiving continuous insulin injection with insulin pump were selected as observation group.Theβfunction index,blood glucose control effect and perioperative complication rate were compared between the two groups.Results Before surgery,there was no significant difference between two groups in isletβfunction in-dexes(all P>0.05).Postoperative review showed that all isletβfunction indexes of the observation group were better than those in control group,and the differences were statistically significant(all P<0.05).Blood glucose index and gly-cosylated hemoglobin level in observation group were lower than those in control group,and the differences were statis-tically significant(all P<0.05).The total incidence of perioperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The incidence of wound infection and complications is higher in patients with diabetes combined with oral and maxillofacial surgery.The main factors include adverse reactions after anesthesia and surgical trauma.In order to control blood glucose sta-bly,continuous subcutaneous injection of insulin pump should be adopted to reduce the risk of postoperative complica-tions and lay a foundation for the healthy prognosis of patients.