微量泵持续泵入胰岛素对重症糖尿病酮症酸中毒患者糖代谢的影响

Effect of Continuous Insulin Pumping by Micropump on Glucose Metabolism in Patients with Severe Diabetic Ketoacidosis

目的探究重症糖尿病酮症酸中毒(Diabetic Ketoacidosis,DKA)患者治疗中微量泵持续泵入胰岛素对糖代谢的影响。方法回顾性选取2023年2月-2024年1月泉州市第一医院收治的110例重症DKA患者的临床资料,所有患者均接受常规对症治疗及胰岛素治疗,根据胰岛素给药方式不同,分为常规组(n=55,静脉缓慢滴注胰岛素)、观察组(n=55,微量泵持续泵入胰岛素),比较两组临床指标、糖代谢水平及不良反应发生情况。结果两组临床指标比较,观察组尿酮体转阴时间(20.32±7.38)h、血pH值恢复时间(10.37±3.45)h及血糖达标时间(4.43±1.25)h时间均短于常规组,差异有统计学意义(t=11.358,8.467,13.407,P均<0.05)。治疗15 d后,观察组血糖水平低于常规组,差异有统计学意义(P<0.05)。观察组不良反应总发生率(3.64%)低于常规组(14.55%),差异有统计学意义(χ^(2)=3.960,P<0.05)。结论重症DKA患者常规对症治疗基础上加入微量泵持续泵入胰岛素方式,临床指标及糖代谢水平改善情况更佳,不良反应发生随之减少。

Objective To investigate the effect of continuous insulin pumping with micropump on glucose metabolism in patients with severe diabetic ketoacidosis(DKA).Methods Clinical data of one hundred and ten patients with se-vere DKA admitted to Quanzhou First Hospital from February 2023 to January 2024 were retrospectively selected.All patients received routine symptomatic treatment and insulin therapy.According to the different methods of insulin ad-ministration,the patients were divided into conventional group(n=55,slow intravenous insulin infusion)and observa-tion group(n=55,continuous insulin pumping by micropump).Clinical indexes,glucose metabolism level and the oc-currence of adverse reactions were compared between the two groups.Results Compared with the clinical indexes of the two groups,the time of urine ketone body turning negative(20.32±7.38)h,the time of blood pH value recovering(10.37±3.45)h and the time of blood glucose reaching standard(4.43±1.25)h in the observation group were earlier than those in the conventional group,and the differences were statistically significant(t=11.358,8.467,13.407,all P<0.05).After 15 days of treatment,the blood glucose level of the observation group was lower than that of the conven-tional group,and the difference was statistically significant(all P<0.05).The total incidence of adverse reactions in ob-servation group(3.64%)was lower than that in conventional group(14.55%),and the difference was statistically sig-nificant(χ^(2)=3.960,P<0.05).Conclusion On the basis of routine symptomatic treatment for severe DKA patients,mi-cropump was added to continuous insulin pumping,and the clinical indexes and glucose metabolism level were im-proved better,and adverse reactions were reduced.