胰岛素泵在肝移植术后糖代谢异常的应用研究

目的探讨肝移植围手术期糖代谢异常的不同处理方法。方法肝移植手术后糖代谢异常患者27例，随机分为连续皮下胰岛素输注组（Continuous subcutaneous insulin infusion，CSII）与多次皮下注射胰岛素组（Multiple daily subcutaneous injection，MDSI）。对两组患者住院期间的血糖控制情况、血糖达标时间、院内感染率、伤口愈合时间、胰岛素用量、低血糖的发生率以及术后半年的糖代谢状态进行比较。结果两组患者血糖均可以达到目标值，CSII组较MDSI组每天胰岛素用量少，血糖达标时间短，切口愈合时间短，院内感染率低。两组患者术后半年的糖代谢状态无显著差异。结论对肝移植术后糖代谢异常的控制，胰岛素泵较传统的多次皮下注射胰岛素更有优势。

Study on the insulin pump used in abnormal glucose metabolism after liver transplantation

Objective To explore the managed methods of perioperative abnomal glucose metabolism in the patients of liver transplantation. Methods From April 2003 to April 2006,27 cases with abnormal metabdism of glucose after liver transplantation were dividedinto 2 groups randomly.One group was treated by continuous subcutaneous insulin infusion(CSII group),another group was control group,which was treated by Multiple daily subcutaneous injection(MDSI group). The controlling status of blood sugar,time of reaching target of glucose,infection rate in hospital,time of wound healing,dosage of insulin,accidence of hypoglycemia and situation of glucose metabolism half year after operation were compared between two groups. Results The blood sugar could reach to target level in two groups.However,in the comparison between CSII group and MDSI group,the former was less dosage of insulin,a shorter time of blood glucose recovering to normal,less time of wound healing and a lower infection rate in hospital. The glucose metabolism status was no difference significantly in two groups 1/2 year after liver transplantation. Conclusion For controlling abnormal glucose metabolism after liver transplantation,the insulin pump is much superior to traditional multiple subcutaneous insulin injection.