胰岛素泵在糖尿病围手术期的临床应用

目的探讨胰岛素泵对围手术期糖尿病患者的治疗效果。方法将84例围手术期糖尿病患者随机分为胰岛素泵治疗（CSII）组43例,多次皮下胰岛素注射（MSII）组41例。比较两组患者在血糖控制,待手术期时间,胰岛素用量,低血糖发生率,手术并发症方面的差异。结果两组患者血糖达标时间、胰岛素用量、低血糖发生率、手术并发症比较,差异有统计学意义（P〈0．01）。结论胰岛素泵能更快的控制血糖,缩短术前待手术期,减少低血糖及手术并发症。     

围手术期糖尿病患者使用胰岛素泵的临床应用研究

目的比较持续皮下胰岛素输注（CSII）法和传统的多次皮下注射胰岛素治疗方法（MSII）在糖尿病患者围手术期的疗效。方法选择围手术期糖尿病患者108例,随机分为治疗组（csⅡ组）和对照组（MSII组）,CSⅡ组给予胰岛素泵持续皮下注射短效门冬胰岛素。对照组于三餐前皮下注射短效门冬胰岛素和睡前（22：00）注射中效诺和灵,术中及术后禁食期则停用餐前胰岛素,只给予基础量。结果CSⅡ组控制血糖达标时间、胰岛素用量、低血糖发生率、术后并发症发生率均明显低于对照组（P〈O．05）。结论CSII较MSII能明显缩短待手术期;明显减少低血糖发生率;明显减少胰岛素用量;能更平稳、更迅速地控制血糖;提高糖尿病患者生活质量。     

胰岛素泵在糖尿病患者围手术期的应用与护理

目的比较胰岛素泵强化治疗(CSII组)和传统的多次皮下注射胰岛素强化治疗(MSII组)在糖尿病患者围手术期的疗效观察与护理。方法将糖尿病围手术期患者82例,随机分为观察组和对照组,观察组41例应用胰岛素泵强化治疗控制血糖,对照组41例于三餐前及睡前强化治疗控制血糖。观察两组术前血糖达标时间、术后血糖波动情况伤口感染、低血糖发生率、住院天数。结果观察组血糖达标时间、切口感染及低血糖发生率住院天数均明显低于对照组(P<0.01)。结论糖尿病患者围手术期应用胰岛素泵可更安全、有效的控制血糖,减少了低血糖及伤口感染的发生,减轻患者痛苦。     

胰岛素泵在糖尿病围手术期中的应用体会

为观察胰岛素泵在糖尿病(DM)围手术期血糖调整中的应用价值。将观察对象随机分为胰岛素泵治疗组(CSII)17例和皮下或静脉胰岛素注射组(MSII组)15例，CSII组按DM围手术期血糖控制目标行胰岛素泵持续下皮下胰岛素注射，MSII组以皮下或静脉胰岛素注射调整血糖。结果表明，CSII治疗能使DM围手术期血糖迅速、平稳地控制，可减少胰岛素用量及低血糖事件的发生，缩短住院日。     

胰岛素泵在2型糖尿病病人围手术期的临床应用

目的探讨胰岛素泵在糖尿病病人围手术期中控制血糖的疗效。方法持续皮下胰岛素输注（CSⅡ）组20例及传统的每日多次皮下胰岛素注射（MSⅡ）组22例，比较两组血糖控制水平、血糖达标时间、低血糖发生情况、胰岛素用量和术后并发症的发生率。结果CSⅡ组与MSⅡ组治疗后，空腹血糖以及餐后血糖均能达标，且两组血糖值治疗前后差异有显著性（P〈0．05）；CSⅡ组平均血糖达标所用的时间明显低于MSⅡ组（P=0．003）；CSⅡ组每日平均胰岛素用量明显少于MSⅡ组（P=0．00）；CSⅡ组的低血糖发生率低于MSⅡ组；CSⅡ组切口感染率低于MSII组。结论CSⅡ与MSⅡ相比，明显缩短术前准备时间、减少胰岛素用量及低血糖发生率，能平稳、迅速控制血糖、降低手术并发症。     

胰岛素泵在2型糖尿病患者外科围手术期的应用及护理

目的观察胰岛素泵在糖尿病患者围手术期血糖调整中的应用效果,总结泵使用过程中的护理经验。方法将32例需行各种外科手术的糖尿病患者均予以佩带胰岛素泵强化胰岛素治疗,同时,结合患者特点予以心理和置泵护理。结果血糖控制天数1～4d、住院总天数8～24d、无低血糖和手术切口感染病例发生。结论糖尿病患者外科围手术期应用胰岛素泵治疗能迅速、平稳地控制血糖,促进手术伤口愈合,降低感染发生率,是一种安全、有效的治疗方法 。     

普外合并糖尿病手术患者围手术期的疗效探讨

目的:针对实施普外手术的糖尿病患者开展控制血糖方法的相关研究,分析手术疗效受血糖控制的影响作用。方法:收集2009年5月-2011年5月合并糖尿病实施普外手术的80例患者,结合对其控制血糖的方法分为观察组与对照组,每组各有患者40例。观察组患者采取胰岛素泵与诺和灵R笔芯控制血糖,对照组患者采取应用诺、灵R笔芯与N笔芯,围手术期结合患者血糖变化对胰岛素用量进行随时调整。结果:两组患者给药后,空腹血糖、餐后2小时血糖与给药前相比下降比较明显,而且观察组比对照组低(P<0.05);观察组患者平均血糖达标时间、抗生素使用时间、术后拆线时间及住院时间都显著低于对照组(P<0.05);对于术后低血糖、感染及酮症等不良并发症,观察组患者发生率比对照组低(P<0.05)。结论:对于实施普外手术的糖尿病患者合理控制血糖,能够使并发症发生率及病死率明显降低,使患者生存质量得到提高。     

糖尿病患者围手术期胰岛素泵治疗的临床护理(综述)

胰岛素泵(持续皮下胰岛素缓释系统,CSⅡ)能够模拟人体胰岛素分泌,改变了传统的多次皮下注射胰岛素的治疗方式,能够短期快速、安全、有效地控制血糖。应用胰岛素泵对围手术期糖尿病患者进行治疗,能够使患者在围手术期的血糖控制平稳,术后并发症的发生率降低,保证手术的安全。本文通过对我国近10年的相关文献进行检索,对糖尿病患者围手术期胰岛素泵的治疗、护理、安全管理等方面进行综述。     

糖尿病白内障围手术期胰岛素治疗方案分析

目的探讨中老年糖尿病白内障患者围手术期采用两种胰岛素治疗方案的临床疗效。方法 42例住院的2型糖尿病白内障患者随机分为二组,一组用胰岛素泵持续皮下胰岛素注射(CSⅡ),另一组为每日多次注射胰岛素(MSⅡ)。观察两组胰岛素用量、待手术时间、住院时间等,分析两种治疗方案对控制空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血清蛋白(GSP)的效果。结果术前人均日胰岛素用量CSⅡ组(36.40±6.00)U,MSⅡ组(46.80±9.97)U;待手术天数CSⅡ组(3.20±0.90)d,MSⅡ组(8.40±2.83)d;住院天数CSⅡ组(9.80±3.30)d,MSⅡ组(14.80±6.62)d;低血糖发生率CSⅡ组为8.70%,MSⅡ组26.32%。治疗后CSⅡ组FPG(5.12±0.63)mmol/L,MSⅡ组(6.26±0.91)mmol/L;CSⅡ组2 h PG(7.41±0.83)mmol/L,MSⅡ组(9.22±1.03)mmol/L。两组差异均有统计学意义(均P<0.01)。结论 CSⅡ较MSⅡ能缩短待手术天数和住院天数,减少胰岛素的用量,低血糖发生率较低,能更平稳、更迅速地控制血糖。     

胰岛素泵在围手术期应用及护理

目的探讨胰岛素泵治疗眼科糖尿病围手术期应用与护理体会。方法应用胰岛素泵对36倒眼科糖尿病患者的围手术期进行强化治疗。结果本组36例患者围手术期血糖控制满意,手术均成功,无严重并发症发生。     

Short acting insulin analogues for treating diabetic patients with CSII (continuous subcutaneous insulin infusion)

The use of insulin pump treatment (CSII: continuous subcutaneous insulin infusion) became widely accepted in the last couple of years. A growing body of experiences accumulated in paediatric practice because CSII is preferable for treating young patients with type 1 diabetes. Nevertheless, CSII can be used, if indicated, for treating type 2 diabetic patients as well. Recently, fast acting insulin analogues are exclusively used for CSII. At moment, clinical observations with insulin lispro and insulin aspart are available but experiences with glulisine are still limited. Although some inconsistencies could be observed in the literature, it is widely accepted, that higher reduction in HbA(1c) values could be achieved by CSII as compared to intensive conservative insulin treatment; this could be more pronounced in cases with high initial HbA(1c) values. CSII with short acting insulin analogues could lead to a higher reduction of HbA(1c) values than CSII with human regular insulin. Moreover, the decrease of hypoglycaemic events could be expected in some cases.     

持续皮下胰岛素输注治疗初诊2型糖尿病的临床研究

目的探讨短期持续皮下胰岛素输注(CSⅡ)治疗初诊2型糖尿病(T2DM)对胰岛β细胞功能的改善和血糖的控制.方法对82例初诊T2DM进行2w CSⅡ治疗.分析比较其空腹血糖(FPG)、餐后2h血糖(2h PG)、胰岛素抵抗指数(Homa A)、胰岛素分泌指数(Homa B)、静脉葡萄糖耐量试验(IVGTr)曲线下的胰岛素、C肽的面积.结果FPG、2h PG分别于治疗(3.5±1.5)d、(8.5±3.5)d后达到良好控制.胰岛素抵抗指数Ho眦A由治疗前的3.9±0.7降至1.9±0.5(P＜0.01),胰岛素分泌指数Homa B由治疗前的9.9±4.7增加至81.6±40.5(P＜0.01),胰岛素、C肽曲线下的面积均较治疗前明显提高.结论对有明显高血糖的初诊T2DM患者进行短期CSⅡ治疗可快速控制血糖和恢复胰岛β细胞功能的作用.     

持续皮下胰岛素输注治疗妊娠期糖尿病的效果观察

目的 分析持续皮下胰岛素输注对妊娠期糖尿病(GDM)患者血糖水平及妊娠结局的影响.方法 以2018年8月—2019年8月本院收治的GDM患者120例为研究对象,采用随机数字表法将其分为对照组和治疗组,各60例,对照组给予常规胰岛素皮下注射治疗,治疗组给予持续皮下胰岛素输注.比较两组患者治疗前后空腹血糖(FBG)、糖化血...     

Enteral hyperalimentation with continuous subcutaneous insulin infusion improved severe diarrhea in poorly controlled diabetic patient

Little is known about effective treatment for severe diarrhea in the insulin-dependent diabetic patient. A 41-year-old woman was admitted to our hospital because of hyperglycemia and dysuria. She had stopped insulin self-injection therapy for 2 years and diarrhea had become worse, resulting in malnutrition. Following enteral alimentation by elemental diet (ED) with continuous subcutaneous insulin infusion (CSII), frequency of diarrhea remarkably decreased and general nutritional condition was improved. At the first step, the patient was given 600 kcal/d ED through the tube sustained in the jejunum. Total calorie intake for 24 hours was gradually increased to the level of 2400 kcal/d and this therapy continued for 5 months. During this period, blood glucose level was kept in almost normal range (between 100 and 200 mg/dL) through the continuous insulin infusion of regular insulin (1.0-1.5 U/h). Thereafter, general conditions were improved and frequency of diarrhea gradually decreased. When this treatment was stopped, watery diarrhea, steatorrhea, and hypoalbuminemia completely disappeared and she gained 12 kg of body weight. Furthermore, spontaneous urination appeared following this treatment. This case suggests that the enteral hyperalimentation combined with strict control of blood glucose, using the CSII, may be an effective therapy for such severe diarrhea with malnutrition in diabetes.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

目的 探讨胰岛素泵治疗使血糖相对平稳后转换为胰岛素多点皮下注射治疗,比较胰岛素泵治疗时的基础量和甘精胰岛索之间的剂量关系及转换前后整体血糖的波动情况.方法 将2006年3月至2008年4月收治的102例2型糖尿病患者应用胰岛素泵治疗使血糖平稳后,改为甘精胰岛素联合门冬胰岛素多点皮下注射治疗,在空腹血糖相对稳定的前提下,观察胰岛素泵基础用量及甘精胰岛素用量,同时比较转换前后全日血糖的波动情况.结果 胰岛素泵的基础量为(0.30±0.11)U/(kg·d),甘精胰岛素的用量为(0.28±0.09)U/(kg·d),两者比较差异无统计学意义;胰岛素泵治疗达标时的日平均血糖为(7.94±1.32)mmol/L,胰岛素多点皮下注射治疗达标时的日平均血糖为(7.49±1.34)mmol/L,两者的日平均血糖分别大于3倍的样本标准差.结论 甘精胰岛素可以起到类似于胰岛索泵基础量模式的作用.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.