胰岛素泵强化降糖疗法应用于糖尿病合并下肢静脉曲张患者大隐静脉曲张微创术后的疗效分析

Effect of Insulin Pump Intensive Hypoglycemic Therapy on Patients with Diabetes Mellitus Complicated with Varicose Veins of Lower Limbs after Minimally Invasive Surgery for Varicose Veins of Great Saphenous Vein

目的探究糖尿病合并下肢静脉曲张患者大隐静脉曲张微创术后应用胰岛素泵强化降糖疗法的临床疗效。方法选择2019年1月—2023年9月连江县总医院收治的200例糖尿病合并下肢静脉曲张患者为研究对象,所有患者均行大隐静脉曲张微创术(激光+硬化剂注射+大隐静脉高位结扎、分段剥脱、三者联合手术)治疗,以治疗方法的不同分为胰岛素治疗组(100例,接受常规胰岛素治疗)和胰岛素泵强化治疗组(100例,接受胰岛素泵强化降糖疗法)。比较两组血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平、血脂(甘油三酯、总胆固醇、高密度脂蛋白及低密度脂蛋白)水平与安全性。结果胰岛素泵强化治疗组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于胰岛素治疗组,差异有统计学意义(P均<0.05)。治疗后,胰岛素泵强化治疗组血脂(甘油三酯、总胆固醇、高密度脂蛋白及低密度脂蛋白)水平显著优于胰岛素治疗组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论将胰岛素泵强化降糖疗法作为糖尿病合并下肢静脉曲张患者大隐静脉曲张微创术后的首选治疗方案,能够更好地控制血糖,减少血糖波动,降低血脂水平。

Objective To explore the clinical efficacy of insulin pump for intensive hypoglycemic therapy in patients with diabetes mellitus complicated with varicose veins of lower limbs after minimally invasive surgery for varicose veins of great saphenous vein.Methods A total of 200 patients with diabetes mellitus complicated with varicose veins of lower extremities admitted to Lianjiang County General Hospital from January 2019 to September 2023 were se-lected as the research objects.All patients were treated with minimally invasive surgery of great saphenous varicose veins(laser+sclerosing agent injection+high ligation of great saphenous vein,segmental stripping,combined surgery of the three).They were divided into insulin treatment group(100 cases,receiving conventional insulin therapy)and insulin pump intensive treatment group(100 cases,receiving insulin pump intensive hypoglycemic therapy)by differ-ent treatment methods.The levels of blood glucose(fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin A1c),blood lipid(triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein)and safety were compared between the two groups.Results The levels of fasting blood glucose,2-hour postprandial blood glucose and glycated hemoglobin A1c in the insulin pump intensive treatment group were lower than those in the insu-lin treatment group,and the differences were statistically significant(all P<0.05).After treatment,the blood lipid(tri-glyceride,total cholesterol,high density lipoprotein and low density lipoprotein)levels in the insulin pump intensive treatment group were significantly better than those in the insulin treatment group,and the differences were statisti-cally significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intensive hypoglycemic therapy with insulin pump is the first choice for patients with diabetes mellitus complicated with varicose veins of lower extremities after minimally invasive surgery for varicose veins of great saphenous vein,which can better control blood glucose,and reduce blood lipid levels.