危重病人强化胰岛素治疗的临床护理研究

目的：探讨强化胰岛素治疗危重病人对预后的影响，并分析相关护理问题。方法：采用前瞻性研究方法，将320例危重病人随机分为观察组和对照组，观察组160例给予强化胰岛素治疗，维持危重病人血糖在4．4—6．1mmol／L；对照组按常规控制在血糖10．0～11．7mmol／L，每2h进行血糖监测和分析。观察指标用SPSS10．0进行统计分析。结果：两组危重病人使用胰岛索天数、机械通气时间、院内感染发生率、死亡率、ICU住院天数经统计学处理无显著差异（P〉0．05），低血糖发生率及危重病人压疮愈合情况两组有统计学差异（P〈0．05）。结论：危重病人强化胰岛素治疗并不能降低病死率，反而增加低血糖反应的发生率。结合其他近期研究的阴性结论，该疗法还不成熟，危重病人实施强化胰岛素治疗还需进一步深入研究。

Clinical nursing observation of intensive insulin therapy in the critical illness patients

t Objective ：To investigate the effect of intensive insulin therapy （IIT） on the critical illness patients. Methods：320 cases of critical illness patients were randomly divided into treatment group and control group,treatment group （n = 160） received IIT, the blood glucose levels were preserved 4.4 - 6.1 mmol/L. While the control group（ n = 160） received routine insulin therapy, the blood glucose levels were preserved 10.0 - 11.7 mmol/L. The days of mainline insulin, the days of using ventilator, the days in ICU, the rats of nosocomial infections, mortality were measured during the study by SSPS 10.0. Results ：The days of mainline insulin, the days of u- sing ventilator, the days in ICU ,the rats of nosocomial infections and mortality were not significantly in two groups（ P 〉 0.05 ）. Pres- sure sore and hypoglycemia in two groups has significantly difference （P 〈 0.05 ）. Conelusion：A policy of lIT in a group of ICUs from a single institution was not associated with a decrease in hospital mortality. These results, combined with the findings from several recent randomized trials, suggest that further study was needed prior to widespread implementation of IIT in critically ill patients.