糖尿病合并胆石症患者术前胰岛素泵强化治疗的临床观察

目的:观察并分析糖尿病合并胆石症患者腹腔镜手术前采用连续皮下胰岛素输注方法(CSII)或多次皮下注射胰岛素方法(MSII)控制血糖的效果,了解胰岛素泵在糖尿病患者手术前使用的价值。方法:162例糖尿病合并胆石症患者随机分为CSII和MSII组。CSII组患者采用经胰岛素泵连续皮下输注胰岛素的治疗方法,MSII组患者采用多次皮下注射胰岛素的治疗方法。胰岛素剂量根据血糖波动曲线调整。比较治疗前后患者的全天血糖变化、血糖达标时间、胰岛素用量及低血糖发生率。结果:两组均可有效降低血糖(P<0.01),但CSII组全天血糖值较MSII组控制更为理想,且胰岛素用量及术前调整时间均少于MSII组。CSII组低血糖发生率低于MSII组。结论:糖尿病合并胆石症患者手术前应用胰岛素治疗降糖效果显著,安全性高。

Efficacy of continuous subcutaneous insulin infusion during preoperative period for patients with diabetes and cholelithiasis

Objective:To investigate the effect of continuous subcutaneous insulin infusion(CSII)or multiple subcutaneous insulin injection(MSII)on controlling blood sugar in patients with calculous cholecystitis and type 2 diabetes before laparoscopic operation on gall bladder.Methods:One hundred and sixty-two hospitalized patients with calculous cholecystitis and high blood sugar were randomly divided into CSII group and MSII group,and the insulin dosage were regulated according to fluctuation of blood glucose level.Blood glucose level,time of well-con- trolled blood glucose level,total amount of insulin used and incidence of hypoglycemia were compared between the groups before and after treatment.Results:Levels of blood glucose were significantly lowered in two groups,but in CSII group the effects were much better in regard to blood glucose level,less total insulin dosage,shorter time for regulation and lower incidence of hypoglycemia.Conclusions:The effect is better,safer,with shorter hospital- ization time,and lower expense in CSII group for patients with type 2 diabetes suffering from calculous cholecysti- tis before laparoscopic operation on gall bladder.