肠外营养中胰岛素输注方式对其活性和浓度以及血糖影响的随机对照研究

目的 比较胰岛素加入全合一营养袋内或经静脉泵同步输注时胰岛素活性、浓度以及患者血糖的变化.方法 将2006年4月至8月20例上消化道肿瘤术后无糖尿病的患者随机分为滴注组和静脉泵组.滴注组为胰岛素直接加入全合一营养袋中静脉滴注,静脉泵组为胰岛素加入注射器内泵入.于开始输液、输液至1000 ml、输液至2000 ml和余液100 ml时测量胰岛素活性百分比、浓度以及患者的血糖水平,连续测量3 d.结果 两组胰岛素的活性百分比和浓度均随时间有下降趋势,活性百分比两组间差异无统计学意义(P=0.347).两组间和组内各时点血糖差异无统计学意义(P>0.05).两组患者未发生与血糖水平相关的并发症.结论 胰岛素加入全合一营养袋内或经静脉泵同步输注两种方式对胰岛素活性、患者血糖和与血糖相关并发症的影响无明显差异.胰岛素可安全地加入营养袋内输注.

Effect of different ways of insulin infusion in parenteral nutrition patients on activation and concentration of insulin and blood glucose control: a prospective randomized comparison study

Objective To compare activation and concentration of insulin,and blood glucose control in patients between insulin added into "all in one" bags and syringes at parenteral nutrition (PN).Methods From April 2006 to August 2006,20 consecutive patients after gastrointestinal operations were recruited and randomized to instillation group and pump group.In instillation group,the insulin was directly added into PN and transfused.In pump group,the insulin was added into syringes and transfused by infusion pump.Activation and concentration of insulin,and blood glucose in patients were measured at beginning infusion,infused 1000 ml,infused 2000 ml,and remained 100 ml daily for the first 3 days after operation.Results There was a tendency of decrease for the activation and concentration of insulin in beth groups with the time.There was no significant difference of activation of insulin between the two groups (P=0.347).There was no significant differences of blood glucoses between the two groups,and between the four time points in each groups (P>0.05).There was no complications association with blood glucoses in the two groups.Conclusions Both of activation and concentration of insulin at PN decreased gradually and slightly with the time no matter the ways of insulin infusion.Activation of insulin and blood glucoses in patients are no significant differences between the two groups.Insulin can be safely added into "all in one" bags at PN.