危重病人行强化胰岛素治疗的临床护理研究

目的研究强化胰岛素治疗在危重病患者中的临床疗效,并分析相关护理问题。方法采用前瞻性研究方法,将160例危重病人随机分为观察组和对照组,观察组80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80例按常规将血糖控制在10.0～11.7mmol/L。观察指标用SPSS10.0进行统计分析。结果观察两组使用胰岛素天数、机械通气时间、院内感染发生率、死亡率、ICU住院天数比较。强化胰岛素治疗组中上述数据均明显低于传统治疗组,差异有显著性(p<0.05)。结论对于危重病患者即使无糖尿病,当出现血糖水平持续升高时,强化胰岛素治疗,可改善危重病患者的病情,降低死亡率,减少感染性并发症发生,但是其实施过程中需要严密监测,进行动态观察和护理,减少低血糖事件的发生,保证治疗效果。

CLINICAL NURSING OBSERVATION OF INTENSIVE INSULIN THERAPY IN THE CRITICAL ILLNESS PATIENTS

Abstract] Objective To investigate the effect of intensive insulin therapy（IIT） on the critical illness patients. Methods 160 cases of critical illness patients were randomly divided into treatment group and control group. Treatment group （ n = 80） received IIT, the blood glucose levels were preserved 4. 4 ~ 6. lmmol/L. While the control group（ n = 80） received routine insulin therapy, the blood glucose levels were preserved 10. 0 ~ 11.7mmol/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. Results The days of mainline insulin , the days of using ventilator , the days in ICU , the rats of nosocomial infections and mortality are significantly different in two groups （p 〈 0. 05 ）. Conclusion When blood sugar elevated continuously in critical patients, even if without diabetes, intensive therapy of insulin can improve the situation of illness, decrease the mortality, reduce the infectious complications; but it must be implemented under strict monitory, dynamic observation and nursing care in order to reduce the incidence of hypoglycemia, ensure the curing effect.