胰岛素泵治疗糖尿病急性并发症的效果观察

目的观察胰岛素泵治疗糖尿病急性并发症的疗效、副作用、住院时间及费用。方法将我院住院的糖尿病急性并发症患者40例（酮症酸中毒28例，乳酸酸中毒2例，高渗昏迷2例，心衰8例）随机分为胰岛素泵皮下榆注组（CSII组，20例）和常规小剂量胰岛素静脉滴注（对照组，20例），两组年龄、血糖和体重指数（BMI）相比无显著差异。观察两组血糖、尿酮体变化．低血糖发生率以及住院时间和费用。结果①两组经治疗后血糖均明显下降，达到目标血糖值的时间（h）相比，CSII组（34．2±10．6）较对照组（52．7±23．5）明显缩短；②CSII组尿酮转阴时间（10．4±4．7）较对照组（49．5±10．2）明显缩短；CSII组低血糖发生率（2．96％）较对照组（8．68％）明显减少；④CSII组住院时间（96．3±34．5）较对照组（135．7±56．8）明显缩短；以上均有显著性差异（P〈0．01）；⑤住院费用（元）CSII组（3365±657）较对照组（3100±456）稍多，二者无明显差异（P〉0．05）。结论胰岛素泵持续皮下输注胰岛素治疗糖尿病急性并发症患者较常规小剂量静脉注射胰岛素疗效更好，更安全。

Effect of Insulin Bump in Treatment of Diabetes of Diabetes with Acute Complications

Objective To observe the effects, side effect, hospital stay and costs of insulin pump in the treatment of diabetes mellitus with acute complications. Methods 40 patients with diabetes mellitus and acute complications （28 cases of diabetic ketoacidosis, 2 cases of lactic acidosis, 2 cases of hyperosmolar coma, 8 cases of congestive heart failure） were divided into two groups： insulin pump group（CSII group, 20 cases） and low dose intravenous infusion treatment group（control group, 20 cases）. Patients in the two groups were matched in age, blood glucose and BMI without significant difference. Blood glucose, urinary ketoacidosis, hypoglycemic incidence, hospital stay and costs were observed in thetwo groups. Results Blood glucose, urinary ketoacidosis, hypoglycemic incidence and hospital stay in the two groups were significantly different （P〈0.01）. But the costs of the two groups didn＇t have significant difference（P〉0.05）. Conclusion Insulin pump treatment was more effective and safe than intravenous insulin infusion in diabetes with acute complications.