胰岛素泵在2型糖尿病患者骨科围手术期的应用研究

目的比较2型糖尿病患者骨科围手术期不同胰岛素治疗方法的疗效及安全性。方法拟行骨科手术治疗的2型糖尿病患者55例,分为胰岛素泵持续皮下输注组(CS II组:25例)和多次皮下注射胰岛素组(M S II组:30例)。比较两种方法在控制血糖、血糖控制时间、胰岛素用量、低血糖发生率、切口感染等方面的差异。结果两组均能获得良好的血糖控制(P<0.01)。CS II组对空腹血糖的控制优于M S II组(P<0.05),术前血糖控制的时间、住院总天数及低血糖发生率均低于M S II组(P<0.01),切口感染率均低于M S II组(P<0.05)。结论围手术期胰岛素泵持续皮下注射能快速有效地控制血糖,缩短术前血糖控制时间及住院总天数,低血糖及切口感染、延迟愈合等并发症的发生显著减少。因此,CS II用于围手术期的血糖控制比M S II更快速、有效、安全。

A clinical match study on perioperative treatment of type 2 diabetes in orthopedics area by continuous subecutaneous insulin infusion with insulin pump

Objective To compare the effects and safety of two different ways of insulin delivery in orthopedics perioperative treatment of Type 2 diabetes.Methods By a match study,differences of blood glucose level,the time needed for reaching well controlled blood glucose level,insulin dosage,hypoglycemia episodes and the infection rate of operation incisions were compared both in continuous subcutaneous insulin infusion(CSII) group with insulin pump(n=25) and multiple subcutaneous insulin infusion(MSII) group(n=30).Results The hyperglycemia could be controlled more effectively and more quickly in CSII group than that in MSII group(P<0.01).The hypoglycemia incidence and the infection rate of operation incisions of CSII group were lower than those of MSII group(P<0.01).Conclusion CSII in orthopedics perioperative treatment can shorten the duration of insulin treatment,control FBS more effectively,and reduce the hypoglycemia risk,which give us a quick,safe,effective new type of method in perioperative insulin treatment.