胰岛素不同给药方法治疗儿童1 型糖尿病的效果观察

目的比较胰岛素的不同给药方法对儿童1 型糖尿病（T1DM）和糖尿病酮症酸中毒（DKA）疗效的差异。方法选择1 型糖尿病（T1DM）患儿223 例，其中T1DM 非糖尿病酮症酸中毒（T1DM 组）患儿125 例，DKA 组患儿 98 例，2 组采用胰岛素泵持续皮下注射胰岛素（CSII）和每日多次皮下注射胰岛素（MSII）治疗，对血糖达标时间、胰岛素用量、尿酮转阴和DKA 纠正时间及低血糖发生率进行比较。结果CSII 和MSII 均能有效控制血糖、纠正酸中毒，但患儿血糖达标时间、胰岛素用量、DKA 纠正时间、尿酮转阴时间及低血糖发生率，CSII 组较MSII 组疗效显著。结论胰岛素泵持续皮下注射胰岛素治疗儿童T1DM 及DKA 能迅速纠正代谢紊乱，且更为安全有效。

Comparison of therapeutic effect of different insulin administration route in treatment of juvenile type 1 diabetes mellitus

Objective To compare the therapeutic efficacy of two different administration routes of insulin administra? tion on juvenile type 1 diabetes mellitus (T1DM) complicated with diabetic ketoacidosis(DKA). Methods A total of 223 cases of juvenile T1DM was included in this study, among which 98 were complicated with DKA. Insulin was delivered through either continuous subcutaneous insulin infusion(CSII) by insulin pump or via multiple subcutaneous insulin injec? tion (MSII). Recovery period of blood glucose, insulin doses that were adminstrated, the urinary ketone bodies clearance time, the recovering time from DKA and the frequency of hypoglycemia incidence were all compared between these two routes. Results Both CSII and MSII routes reversed blood glucose and DKA effectively. However the recovering time of blood glucose and DKA, insulin dosage，the urinary ketone bodies clearance time and the frequency of hypoglycemia inci? dence all improved better or quicker in CSII than in MSII. Conclusion CSII by insulin pump is safer and more effective than MSII in the treatment of junvenile T1DM with metabolic disturbance and diabetic ketoacidosis．