糖棉签吸吮缓解早产儿静脉穿刺疼痛的效果观察

目的探讨糖棉签吸吮减轻早产儿静脉穿刺疼痛的效果,为其疼痛管理提供依据。方法选取福建省妇幼保健院儿科住院早产儿100例,胎龄32~36周、吸吮速度≥30次/min、体重1 500~2 000g,分为实验组和对照组各50例。实验组在静脉穿刺前2min用糖棉签吸吮至穿刺结束共12min;对照组按常规护理。比较两组心率(HR)、经皮氧饱和度(SpO2)及新生儿疼痛(NIPS)评分,以及穿刺不同时间的评分。比较干预措施缓解疼痛的临床效果。结果实验组操作时及操作后心率加快有减轻、经皮氧饱和度较高、NIPS评分提示疼痛有减轻。结论糖棉签吸吮可明显减轻早产儿静脉穿刺时的疼痛反应,值得临床推广应用;早产儿疼痛可用心率、经皮氧饱和度和疼痛评分量表进行综合评估。     

静脉丙种球蛋白应用对早产儿血糖的影响

目的:观察静脉注射用人免疫球蛋白对早产儿血糖的影响。方法:用罗氏血糖仪监测需静脉应用人免疫球蛋白输注的早产儿免疫球蛋白输入前、输入2h后血糖的变化。结果:57例早产儿使用静脉用免疫球蛋白前平均血糖浓度为(3.6±0.9)mmol/L,在输免疫球蛋白中,血糖均发生升高,升至(5.7±1.1)mmol/L,差异非常显著。结论:静脉注射用人免疫球蛋白可引起早产儿血糖升高。     

甘精胰岛素联合阿卡波糖治疗2型糖尿病临床观察

目的观察甘精胰岛素联合阿卡波糖治疗2型糖尿病的疗效及安全性。方法选择应用甘精胰岛素治疗血糖控制不佳的2型糖尿病患者58例,随机分为两组,每组29例,对照组单用甘精胰岛素;治疗组应用甘精胰岛素加阿卡波糖治疗,3个月后观察两组治疗前后的空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（GHbA1C）的变化,并记录不良反应发生情况。结果对照组的FPG、2hPG、GHbA1C治疗前后变化不明显,治疗组FPG、2hPG、GhbA1C较治疗前明显下降,差异有统计学意义（P〈0．05）。结论甘精胰岛素联合阿卡波糖治疗2型糖尿病有较好疗效,尤其餐后高血糖改善更显著,且无严重不良反应。     

术前糖负荷促进胰岛素早相分泌维持围手术期血糖平稳

目的:在围手术期营养支持严格热量控制的情况下,观察病人围手术期血糖的变化,并探讨术前糖负荷对围手术期血糖的影响。方法:选择60例择期行结直肠手术的病人,随机分为两组。试验组病人术前给予糖负荷,而对照组则按传统的围手术期方案不给予糖负荷,观察两组病人围手术期的胰岛素分泌状况和血糖变化情况。结果:手术病人于术后血糖均明显升高,至术后第6天仍处于应激性高血糖状态。两组病人手术当天血糖变化曲线存在明显差异,对照组在手术期间无明显胰岛素分泌,并出现明显的应激性高血糖,而试验组在手术期间出现明显的胰岛素分泌,并且血糖保持更为平稳。结论:手术可导致病人出现应激性高血糖,术前给予糖负荷可促进胰岛素早相分泌,有利于围手术期病人的血糖控制。     

静脉营养对早产儿体重增长的临床观察

目的探讨静脉营养对早产儿体重增长的临床价值及安全性。方法 2009年12月～2011年12月在我院新生儿科住院的早产低出生体重儿进行回顾性分析,在传统的对因、对症治疗基础上,根据应用静脉营养与否分成静脉营养组跟对照组,对体重增长及各种并发症进行对比。结果静脉营养组的体重增长快,出院时体重增长高于对照组,且静脉营养组患儿未发生静脉炎、高血糖、胆汁淤积、肝肾功能损害等不良反应。结论静脉营养能改善早产儿营养状况,更快更早的增长体重,提高存活率,降低死亡率,不良反应少,对早产儿的治疗有重要意义。     

病理状态下新生儿输糖时进食对血糖的影响

目的:探讨新生儿以6～8 mg/kg.min的速率静脉输糖时进食,餐后血糖的变化,更科学地指导临床输糖速度。方法:对52例住院新生儿以6～8 mg/kg.min速率静脉输糖时于空腹、餐后1 h、2 h监测血糖值。结果:空腹血糖值全部正常。餐后1 h、2 h有4例出现高血糖,其中具有多项可能导致医源性高血糖内在危险因素(早产、低体重、小日龄、严重感染、缺氧)者发生高血糖率达30%。结论:新生儿以6～8 mg/kg.min的速率静脉输糖,在空腹时是安全的,但餐后1～2 h仍可能出现高血糖。对有多项导致医源性高血糖危险因素者,此时应常规监测血糖,随时调慢输液速度。     

早产儿血糖紊乱与C肽、胰岛素和皮质醇的关系

目的 探讨早产儿血糖紊乱的特点及影响血糖变化的高危因素.方法 对70例早产儿和50例足月儿进行血糖及C肽、胰岛素和皮质醇监测.结果 早产儿和足月儿发生血糖紊乱的比例分别为44.3 %和6.0 %;孕34～37周早产儿出生后24 h血糖水平高于其它两组早产儿,但低于足月新生儿;孕32周～、34～37周早产儿出生后24 h皮质醇水平低于足月新生儿组,孕周＜32周早产儿出生后24 h及出生后3 d皮质醇水平高于足月新生儿组,差异均有统计学意义.早产儿与足月儿C肽、胰岛素水平比较,差异无统计学意义.结论 早产儿血糖紊乱发生率高,早期皮质醇水平可能是影响血糖变化的高危因素,加强早产儿血糖监测可有效防治早产儿血糖紊乱及其带来的不良后果.     

早产儿非脂肪乳静脉营养治疗的临床观察

【目的】探讨非脂肪乳静脉营养能否满足早产儿早期生长发育的能量需要,以及了解静脉营养临床应用的常见并发症。【方法】分别测量3组不同营养方法支持的94例早产儿2周时的体重,并观察住院期间各组患儿腹泻、消化道出血发生率及转氨酶、胆红素升高情况。【结果】非脂肪乳静脉营养组与脂肪乳静脉营养组早产儿体重增长无差异(P>0.05),非脂肪乳静脉营养组与葡萄糖治疗组比较差异有显著性(P<0.05);非脂肪乳静脉营养组与脂肪乳静脉营养组转氨酶及胆红素增高情况比较差异有显著性(P<0.05),非脂肪乳静脉营养组与葡萄糖治疗组腹泻及消化道出血发生率比较差异有显著性(P<0.05)。【结论】非脂肪乳静脉营养能够满足早期早产儿生长发育的能量需要,并能减少常见消化系统并发症的发生。     

早产儿经大隐静脉置入中心静脉导管

经外周置入中心静脉导管（peripherally inserted central catheter，PICC）是新生儿静脉开放的最佳途径。多用于危重和极低出生体重儿，可为其治疗提供有效的静脉通路。PICC常见的静脉穿刺部位为贵要静脉、肘正中静脉和头静脉，但当患儿双上肢肘部静脉不明显或已被破坏无法进行穿刺置管，且病情重、体重轻、预计输液时间在2周以上时，应选择股静脉或大隐静脉置管。我院新生儿重症监护室于2007年8月-12月共为4例早产儿行经大隐静脉置入PICC导管，均获成功，现报告如下。     

早产儿血清瘦素及胰岛素与体格生长发育关系

目的:探讨早产儿血清瘦素及胰岛素水平的变化及其与早产儿体格生长发育的关系。方法:收集自2006年2月～2007年2月在汕头大学医学院第一附属医院新生儿中心住院的30例无严重疾病早产儿的临床资料,以放射免疫分析法检测其在不同日龄(生后第1、第7、第12天)血清瘦素及胰岛素水平,分析不同日龄早产儿体重指数(BMI)的变化及其与血清瘦素、胰岛素之间的关系。结果:早产儿BMI及血清瘦素、胰岛素水平均存在出生第7天下降、第12天回升的趋势(P0.01),体重指数与血清瘦素及胰岛素水平在不同日龄呈正相关(P0.01);血清瘦素与胰岛素水平在不同日龄存在正相关(P0.01)。结论:随着早产儿体格生长发育,血清瘦素及胰岛素水平也有相应的变化,存在正相关关系;瘦素、胰岛素在一定程度上反应早产儿的营养状态,在调节早产儿的生长代谢方面发挥重要作用。     

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.     

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.     

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.     

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.