胰岛素强化治疗对胃肠道恶性肿瘤术后应激性高血糖的治疗价值

目的:研究胰岛素强化治疗对胃肠道恶性肿瘤术后应激性高血糖的治疗价值。方法:将315例胃肠道恶性肿瘤术后出现血糖升高的患者以随机抽样法分为观察组(胰岛素强化治疗组,156例)及对照组(常规胰岛素治疗组,159例),观察组应用胰岛素维持血糖至6.1 mmol.L-1以下,对照组至11.1 mmol.L-1以下,观察胰岛素使用情况、血糖水平、并发症发生率。结果:系统性感染、局部感染、消化道瘘的发生率及感染的持续时间比较,观察组均较对照组低,差异具有统计学意义(P<0.05);但低血糖的发生率比较,观察组较对照组增高(P<0.05)。结论:胰岛素强化治疗,能降低胃肠道肿瘤术后系统性感染、局部感染、肠瘘的发生率,缩短感染的持续时间,但增加了低血糖症的发生率。

Therapeutic Value of Intensive Insulin Therapy for Stress Hyperglycemia in Patients after Undergoing Surgery for Malignant Gastro-intestinal Tumor

OBJECTIVE:To investigate the therapeutic value of intensive insulin therapy for stress hyperglycemia in patients after undergoing surgery for malignant gastro-intestinal tumor.METHODS: 15 patients with elevated blood glucose after undergoing surgery for malignant gastro-intestinal tumor were randomized to either trial group(intensive insulin therapy group,n=156) or control group(routine insulin therapy group,n=159).The blood glucose level was maintained at below 6.1 mmol·L-1 using insulin for the trial group and at below 11.1 mmol·L-1 for the control group.The use of insulin,the blood glucose level and the incidence of complications in the two groups were followed.RESULTS: The incidence rates of systemic or local infection and digestive tract fistula as well as the duration of infection in the trial group were lower than in the control group(P<0.05),whereas the incidence rate of hypoglycemia in the trial group was higher than in the control group(P<0.05).CONCLUSION: Intensive insulin therapy resulted in lower incidences of postoperative systemic or local infection and intestinal fistula and shorter duration of infection but higher incidence of hypoglycemia.