胰岛素强化治疗急性胰腺炎并发应激性高血糖的临床分析

【目的】探讨胰岛素强化治疗用于急性胰腺炎（acute pancreatitls，AP）并发应激性高血糖患者的效果及对预后的影响。【方法】将怀化市四医院及湖南省人民医院2006年1月至2008年6月收治的95例AP并发应激性高血糖患者，分为两组：A组55例采用微量胰岛素持续泵入强化治疗，B组40例采用常规胰岛素治疗。治疗一周内观察患者血糖、急性生理学与慢性健康状况评分Ⅱ系统（APACHEⅡ）评分、胰岛素及抗生素使用时间、住院时间和病死率的变化。【结果】两组治疗后血糖均有明显下降（P〈0．05），病死率差异无统计学意义（P〉0．05）；A组APACHEⅡ评分较治疗前显著下降（P〈0．01），胰岛素及抗生素应用时间、住院天数均显著短于B组（P〈0．01）；B组治疗前后APACHEⅡ评分差异无统计学意义（P〉0．05）。【结论】胰岛素强化治疗是改善AP预后的有益治疗手段之一。

Clinical Analysis of Intensive Insulin Therapy for Acute Pancreatitis Complicated with Stress Hyperglycemia

Objective]To study the clinical effect of intensive insulin therapy on acute pancreatitis(AP) complicated with stress hyperglycemia and its prognosis. Methods] A total of 95 cases of AP complicated with stress hyperglycemia collected from Jan. 2006 to Jun. 2008 in two hospitals were randomly divided into two groups (group A and group B). Fifty five cases of group A were taken insulin therapy intensified into a continuous pump and 40 cases of group B were treated with conventional insulin treatment. The changes of blood sugar, APACHE II scores, the hospitalization time, the consumption of antibiotics and insulin and the mortality rate of all cases of two groups in a week were observed. Results]The blood sugar of two groups decreased significantly after treatment, and the difference was significant(P<0.05). The difference was not statistical significance in the mortality between two groups (P>0.05). APACHE Ⅱ score of intensive treatment group after treatment decreased markedly as compared with before treatment, and there were significant difference in the hospitalization time, consumption of antibiotics and insulin between two groups(P<0.01). No statistical significance was found in APACHE Ⅱ score of group B between before and after treatment(P>0.05). Conclusion] Intensive insulin therapy is a beneficial method for improving the prognosis of acute pancreatitis.