不同胰岛素法治疗1型糖尿病患儿酮症酸中毒的临床效果

Clinical Practice of Different Insulin Treatments for Ketoacidosis in Children with Type 1 Diabetes

目的探讨胰岛素多次和持续注射治疗1型糖尿病患儿酮症酸中毒的临床效果。方法选取2021年4月—2023年4月淄博市妇幼保健院收治的82例1型糖尿病酮症酸中毒患儿为研究对象,根据不同治疗方法分为两组,各41例,对照组采用胰岛素多次皮下注射,观察组采用胰岛素泵皮下持续注射,比较两组血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、恢复时间(血糖达标、血酮恢复、尿酮体转阴及血pH值恢复时间)、胰岛素用量及不良事件。结果治疗3个月、6个月后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白均降低,且观察组均低于对照组,差异有统计学意义(P均<0.05)。观察组血糖达标、血酮恢复、尿酮体转阴及血pH值恢复时间均短于对照组,胰岛素用量少于对照组,差异有统计学意义(P均<0.05)。观察组不良事件发生率为4.88%(2/41),低于对照组的21.95%(9/41),差异有统计学意义(P<0.05)。结论1型糖尿病酮症酸中毒患儿采取胰岛素泵皮下持续注射可促进血糖恢复正常,促进血酮、尿酮、pH值快速恢复,而且胰岛素用量少,不良事件少,提高安全性。

Objective To investigate the clinical effect of multiple and continuous insulin injection in the treatment of ketoacidosis in children with type 1 diabetes mellitus.Methods A total of 82 children with type 1 diabetic ketoacidosis admitted to Zibo Maternal and Child Health Hospital from April 2021 to April 2023 were selected as the research objects.According to different treatment methods,the patients were divided into two groups,41 cases in each group.The control group received multiple subcutaneous injections of insulin,and the observation group received continuous subcutaneous injections of insulin pump.The blood glucose level(fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin A1c),recovery time(blood glucose compliance,blood ketone recovery,urine ketone body negative and blood pH recovery time),insulin dosage and adverse events of the two groups were compared.Results After 3 months and 6 months of treatment,fasting plasma glucose,2-hour postprandial plasma glucose and glycated hemoglobin A1c in the two groups decreased,and those in the observation group were lower than the control group,and the differences were statistically significant(all P<0.05).The time of blood glucose reaching the standard,blood ketone recovery,urine ketone body turning negative and blood pH value recovery in the observation group were shorter than those in the control group,and the dosage of insulin was less than that in the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse events in the observation group was 4.88%(2/41),which was lower than 21.95%(9/41)in the control group,and the difference was statistically significant(P<0.05).Conclusion The continuous subcutaneous injection of insulin pump in children with type 1 diabetic ketoacidosis can promote the recovery of blood glucose,promote the rapid recovery of blood ketone,urine ketone and pH value,and the dosage of insulin is less,the adverse events are less,the safety is improved.