微量泵入胰岛素在控制重症急性胰腺炎高血糖及其强化治疗中的应用

目的：探讨微量泵入胰岛素在控制重症急性胰腺炎（SAP）高血糖及其强化治疗中的疗效。方法：将75例SAP高血糖患者随机分为两组，微量注射泵静脉注射胰岛素治疗（微泵组）和传统静脉滴注胰岛素治疗（传统组）。当血糖〉13．9mmol／L以上，开始剂量为0．1U／（kg·h^-1）的速度泵注或滴注胰岛素。每2h用血糖仪测指血糖，2h后血糖无下降，将剂量加倍。当血糖降至13．9mmol/L以下．根据VANDENBERGHE胰岛素强化治疗方案调整胰岛素用量。结果：微泵组控制血糖至13．9mmol／L所需时间、强化治疗中血糖波动值、ICU住院天数均明显低于传统组（P〈0．05）。结论：微量泵入胰岛素控制SAP高血糖较传统静脉滴注胰岛素能迅速、平稳、精确、有效、安全地降血糖．在血糖基本平稳后的强化治疗中能保持血糖稳定．减少了ICU住院天数。

Effective observation of controlling hyperglycaemia and intensive treatment in severe acute pancreatitis with micro pumping insulin

Objective：To observe the effect of controlling hyperglycaeraia and intensive treatment in severe acute panereatitis with micro pumping insulin. Methods：To divide 75 patients with severe acute pancreatitis into two groups randomly,micro pumping insulin group（micro pump group）and intravenous drip group（tradition group）.The speed of the beginning dose was 0.1 U/kg.h^-1 in micro pumping or dripping insulin when blood glucose was over 13.9mmol/L.To measure finger blood glucose per 2 h with blood glucose apparatus. To double the dose if the blood glucose does not descent obviously.The dose was adjusted according to VAN DEN BERGHE intensive insulin treatment plan if the value was below 13.9 mmol/L Results：In the micro pump group, the time of controlling blood glucose to 13.9 mmol/ L,fluctuation of blood glucose value and length of stay in ICU obviously decreased comparing with the tradition group （P〈0.05）. Conclusion：Micro pumping insulin can control blood glucose rapidly, steadily, exactly, effectually and safely, keep glucostasis in the course of intensive treatment and reduce length of stay in ICU.