胰岛素泵联合门冬胰岛素治疗2型糖尿病重型颅脑损伤的临床观察

目的探讨胰岛素泵联合门冬胰岛素（CSII）治疗2型糖尿病（T2DM）重型颅脑损伤的临床疗效。方法选择T2DM重型颅脑损伤（GCS评分小于8分）的患者87例,在颅脑损伤综合治疗的基础上,分为胰岛素泵联合门冬胰岛素组（CSII组,n=42）和常规人胰岛素多次皮下注射组（MSII组,n=45）,观察两组治疗后血糖控制情况、血糖达标时间、每日胰岛素用量、低血糖发生率、重型颅脑损伤的有效率和住院时间。结果两组治疗后空腹血糖及平均随机血糖均较治疗前明显降低,且CSII组较MSII组降低更明显（P〈0.05）;CSII组较MSII组在血糖达标时间、每日胰岛素用量、低血糖发生率、重型颅脑损伤的有效率、住院时间上差异显著（P〈0.05）。结论胰岛素泵联合门冬胰岛素治疗T2DM重型颅脑损伤,能有效地控制血糖,缩短血糖达标时间和住院时间,减少每日胰岛素用量,减少低血糖发生,而且能显著提高重型颅脑损伤的治疗效果。

Clinical efficacy of insulin pump combined with insulin aspart for type 2 diabetes mellitus complicated with severe craniocerebral injury

Objective To investigate the therapeutic effect of continuous subcutaneous insulin aspart injection（CSII） on type 2 diabetes mellitus complicated with severe craniocerebral injury.Methods Totally 87 patients with type 2 diabetes mellitus and severe craniocerebral injury were selected（GCS score lower than eight point） and randomized into continuous subcutaneous insulin aspart pump injection group（CSII group,n=42） and multiple subcutaneous human insulin injection（MSII group,n=45）.After treatment,the levels of blood glucose,glycemic control time,daily insulin dosage,incidence of hypoglycemia,effective percentage of severe craniocerebral injury and hospitalization duration were compared between two groups.Results The levels of fast blood glucose and random blood glucose were significantly lowered after treatment in both groups,and the decreasing extent was more obvious in CSII group than that in MSII group（P0.05）.Significant differences were observed in glycemic control time,daily insulin dosage,incidence of hypoglycemia,effective percentage of severe craniocerebral injury and hospitalization duration between two groups（P0.05）.Conclusion Insulin pump combined with insulin aspart is effective for type 2 diabetes mellitus complicated with severe craniocerebral injury.It can effective control blood glucose,shorten glycemic control time and hospitalization duration,reduce daily insulin dose and incidence of hypoglycemia as well as increase effective percentage of severe craniocerebral injury.