不同剂量胰岛素治疗小儿糖尿病酮症酸中毒临床效果及血糖指标分析

Clinical Effect and Blood Glucose Index of Different Doses of Insulin in the Treatment of Diabetic Ketoacidosis in Children

目的观察小儿糖尿病酮症酸中毒应用不同剂量胰岛素治疗的效果及血糖变化。方法临床资料采集该院2016年7月—2018年7月治疗的80例DKA患儿,分2组,每组40例,对照组常规剂量胰岛素治疗,观察组微量持续泵注胰岛素,比较两组血糖及治疗情况。结果观察组1、24 h血糖(21.21±2.14)mmol/L、(12.06±2.71)mmol/L均比对照组水平低,尿酮体转阴(47.11±3.21)h、pH值恢复(1.12±0.25)h、血糖达标(5.82±1.14)h均比对照组时间短,差异有统计学意义(P<0.05);观察组酸中毒纠正(5.81±3.20)h、24 h胰岛素用量(12.05±2.74)U、住院时间(7.62±2.05)d均比对照组少,差异有统计学意义(P<0.05),观察组低血糖比对照组15.00%低,差异有统计学意义(P<0.05)。结论小儿糖尿病酮症酸中毒通过微量持续泵注胰岛素治疗后,能迅速控制血糖稳定,加快纠正酸中毒,胰岛素用量少,且无低血糖发生,安全有效。

Objective To observe the effect of different doses of insulin and the changes of blood glucose in children with diabetic ketoacidosis. Methods Clinical data were collected from 80 children with DKA treated in our hospital from July 2016 to July 2018 and were divided into 2 groups, 40 cases in each group. The control group received routine doses of insulin. The observation group was continuously pumped with insulin, compare the blood glucose and treatment of the two groups. Results In the observation group, blood glucose(21.21±2.14)mmol/L and(12.06±2.71)mmol/L were lower than the control group at 1 and 24 h, urinary ketone body turned negative(47.11±3.21)h, and PH value recovered(1.12±0.25)h. The blood glucose level(5.82±1.14)h was shorter than the control time,the different was statistically significant(P<0.05);the observation group was corrected for acidosis(5.81±3.20)h, 24 h insulin dosage(12.05±2.74)U, hospitalization time(7.62±2.05)d was less than the control group,the different was statistically significant(P<0.05), and the hypoglycemia of the observation group was lower than that of the control group(15.00%),the different was statistically significant(P<0.05). Conclusion Pediatric diabetic ketoacidosis can quickly control the stability of blood glucose after a small amount of continuous pumping insulin injection, accelerate the correction of acidosis, less insulin, and no hypoglycemia, safe and effective.