双泵法对胰十二指肠切除术后重症患者早期血糖控制的作用

目的 探讨输液泵和微量泵联合应用对胰十二指肠切除术后早期重症患者血糖控制有效性和安全性的影响.方法 将60例胰十二指肠切除术后早期重症患者随机分为2组,对照组30例,遵医嘱按葡萄糖4 g:中性胰岛素1 U配制含糖液体静脉滴注,中性胰岛素50 U加入生理盐水50 ml经微量泵静脉注射,根据血糖控制方案调整泵速维持患者血糖在4.4～8.3 mmol/L.实验组30例,胰岛素不加入含糖液体,采用输液泵控制含糖液体24 h匀速输入,中性胰岛素50 U加入生理盐水50 ml经微量泵按葡萄糖4 g:中性胰岛素1 U与含糖液体经同一条静脉同步静脉注射,以此为基础量,再结合血糖控制方案调整微量泵速维持患者血糖在4.4～8.3 mmol/L.比较2组血糖控制的水平、安全性、有效性及护士工作量.结果 与对照组比较,实验组高血糖指数(highperglycemic index,HGI)和达到靶血糖范围的时间明显降低,维持靶血糖范围的时间明显延长;遵医嘱给予50%葡萄糖抢救治疗的次数明显低于对照组;发生严重低血糖的次数和护士工作量等方面,2组间比较无显著差异.结论 双泵法能改善重症患者血糖控制的有效性及安全性,而护士工作量无明显增加,因此较传统血糖控制方法更为合理.

Efficacy of control blood sugar by double-pump among severe patients with duodenectomy

Objective To know the efficacy and safety of the blood sugar control by double-pump a-mong severe patients with duodenectomy. Methods Divided 60 severe patients with doudenectomy into the experimental group and the,control group randomly, there were 30 cases in each group. In the control group, pa-tients received intravenous infusion with the liquid containing glucose and neutral insulin (4g: 1 U), intravenous injection of 50U neutral insulin added into 50ml normal saline by micro-pump, the pump speed was In the ex-perimental group, sugar-containing liquid without insulin was infused within 24 hours by infusion pump with u-niform speed, a neutral insulin 50U mixed with 5Oral normal saline were injected by micro-pump according to the ratio fo glucose 4g: 1U neutral insulin through the same vein. Which also adjusted the pump speed according to maintaining blood sugar in the range of 4.4～8.3mmol/L. Compared the level of blood sugar control, treatment safety, efficacy and the workload of nurses between the two groups. Results The highperglycemic index and the time to achieve target values of blood sugar in the experimental group was shorter than in the control group respectively, while the time of keep blood sugar in idea level in the experimental group was longer than in the control group. There were no significant difference about incidence rale of hypoglycemia and workload of nurses between the two groups. Conclusions Double-pump can effective control blood sugar for severe patients with duodenectomy without burden nurses' workload, which is more reasonable than the traditional method.