胰岛素泵在糖尿病酮症酸中毒中的应用效果观察

Obeservations on the effects of insulin pump in treatment of diabetic ketoacidosis

目的 :比较不同胰岛素给药方法对糖尿病酮症 (DK)或酮症酸中毒 (DKA)的治疗差异。方法 :将我院住院的DK或DKA病人随机分为皮下胰岛素泵治疗组 (CSII组 )和常规小剂量胰岛素静脉滴注治疗组 (对照组 )各 2 2例 ,两组年龄、血糖和体重指数 (BMI)相比无显著性差异。分别使用胰岛素泵皮下输注胰岛素和小剂量胰岛素静脉滴注 ,观察血糖、血酮、尿酮体的变化及低血糖的发生率。结果 :(1)两组患者的血糖经治疗后均明显下降 ,但达目标血糖值的时间相似 ,差异无显著意义。 (2 )两组患者血酮经胰岛素治疗后均恢复正常 ,但CSII组血酮恢复时间〔(3 4± 0 4 )d〕较对照组〔(4 8± 0 5 )d〕明显缩短 ,差异有显著性 (P <0 0 5 )。 (3 )尿酮体转阴时间〔(10 9± 4 7)h〕亦较对照组〔(47 5± 11 3 )h〕明显缩短 ,差异有显著性 (P <0 0 1)。 (4)CSII组低血糖发生率〔(0 6± 0 6)次 人〕较对照组〔(1 3± 0 7)次 人〕明显减少 ,差异有显著性 (P <0 0 1)。结论 :胰岛素泵持续皮下输注胰岛素治疗DKA较常规小剂量静脉注射胰岛素疗效更安全。

Objective:To compare the effects of two different ways of insulin delivery on diabetic ketoacidosis(DKA).Method:44 patients with DKA or DK were divided to two groups with 22 cases in each:insulin pump treated group(CSII group) and low dose intravenous infusion treated group(control group).Patients in two groups were matched in age,blood glucose and BMI.The average recovering time of blood glucose,blood ketoacidosis and urinary ketoacidosis and the frequency of hypoglycemia incidence were observed in two groups.Results:The level of blood glucose control in two groups is similar after treatment.The average recovering time of blood glucose in two groups was not significantly different.There was a significantly different in two groups of the recovering time of blood ketiacidosis〔CSII group(3 4±0 4)d,control group(4 8±0 5)d (P<0 05)〕.It took(10 9±4 7)h in CSII group and (47 5±11 3)h in control group to reverse the urinary ketoacidosis,which were significently different(P<0 01).The frequency of hypoglycemia incidence in CSII group was(0 6±0 6) time/case,and in control group was(1 3±0 7) time/case(P<0 01).Conclusion:The treatment of insulin pump was more effectively and safely than intravenous insulin infusion in patients with DKA or DK.