微量泵持续胰岛素泵入治疗脑出血昏迷病人高血糖状态的临床研究

A CLINICAL STUDY ON TREATMENT OF COMATOSE CEREBRAL HEMORRHAGE PATIENTS WITH HYPERGLYCEMIA BY CONTINUOUS INTRAVENOUS INJECTION OF INSULIN WITH MICROPUMP

目的 :比较不同胰岛素给药方法对脑出血昏迷病人高血糖治疗的差异。方法 :5 6例脑出血昏迷高血糖病人随机分两组进行 2种胰岛素强化治疗 :1微量泵连续静脉输注胰岛素治疗 ( 2 7例 ) ;2多次皮下注射胰岛素治疗 ( 2 9例 )。两组治疗靶细胞值均为三餐前及睡前末梢血糖≥ 3.9mmol/L,≤ 7.0 mmol/L并至少持续 3d。结果 :两种治疗平均高血糖控制天数〔微量泵组 ( 1 4.5± 4.6) d,多次皮下注射组 ( 2 2 .4± 7.5 ) d,P<0 .0 1〕两组间有极显著性差异。微量泵组低血糖发生低于多次皮下注射组〔微量泵组 :( 0 .8± 1 .1 )次 /人 ,皮下注射组 :( 1 .8± 2 .4)次 /人 ,P<0 .0 5〕。结论 :微量泵更适合脑出血昏迷病人治疗 ,可有效地控制高血糖 。

Objective:To compare the effects of two different ways of insulin delivery on blood sugar in hyperglycemic patients with comatose complicated by cerebral hemorrhage.Methods:56 poorly controlled patients were studied by 2 methods of intensive insulin delivery:①Continuous intravenous injection of insulin with micropump (CIII) ( n =27);②Multiple subcutaneous injection(MSI)( n =29).The target BGs for both groups were premeal and bedtime BGs≥3 6 mmol/L≤7 2 mmol/L for at least 3 days.Results:The average durations of treatment〔CIII:(14 5±4 6)d,MSI:(22 4±7 5)d, P <0 01〕were significantly different.The hypoglycemia incidence in CIII was (0 8±1 1) time/case and in MSI(1 8±2 4) time/case( P <0 05).Conclusion:CIII;could control hyperglycemia much faster and more effectively than MSI.