早期综合护理干预对PICU应激性高血糖患儿治疗转归的影响

目的:探讨儿科重症监护室(PICU)应激性高血糖患儿更佳的护理方法.方法:将血糖＞10.1 mmol/L患儿45例随机分为观察组23例和对照组22例.两组患儿均在限糖输注基础上给予胰岛素0.1～0.2 u/kg皮下或静脉注射.观察组采取早期综合护理干预,对照组采取常规护理方法.结果:两组12例患儿中于3天内死亡,其余两组患儿进入危重恢复期时间及血糖恢复正常(＜7 mmol/L)时间有显著性差异(P＜0.05).结论:小剂量胰岛素治疗PICU应激性高血糖安全有效,早期综合护理干预对小剂量胰岛素治疗PICU应激性高血糖治疗转归有重要意义.

Influence study of comprehensive care and early intervention on treatment outcome in PICU stress hyperglycemia

Objective：To study the better care methods to the children patients with stress hyperglycemia in pediatric intensive care unit （PICU）.Methods：189 patients were taken blood to measure the blood sugar after admission to hospital.Then,the trace glucose meter was used for dynamic monitoring of blood glucose. 45 children patients with blood glucose10.1 mmol/L were randomly divided into two groups, the observation group （23 cases） and the control group （23 cases）.Two groups were given 0.1-0.2u/kg insulin by subcutaneous or intravenous injection on the basis of limited glucose infusion.The observation group adopted the early integrated care intervention,while the control group used the conventional nursing method.Results：In the two groups,6 cases died within 3d, and the remaining patients were successfully rescued into the critical group for recovery. The time entering to critical recovery stage and the time of blood glucose returning to normal （7 mmol/L） had significant difference between the two groups （P0.05）.Conclusion：Low dose insulin for treating stress hyperglycemia in PICU is safe and effective.Early comprehensive care intervention has important significance to the treatment outcome of stress PICU hyperglycemia treated by low-dose insulin.