胰岛素泵治疗危重患者应激性高血糖的临床观察

目的探讨采用胰岛素泵控制危重伴应激性高血糖的临床疗效。方法将112例危重伴应激性高血糖患者随机分为胰岛素泵（CSII）组和每日多次皮下胰岛素注射（MDII）组各56例。两组患者均给予常规治疗,此外,分别加用CSII和MDII治疗,使血糖维持在6.1～8.3mmol/L。结果两组血糖达标时间、每日胰岛素用量、达标后血糖水平及住院时间比较均差异有统计学意义（P〈0.01）,CSII组优于MDII组。CSII组低血糖发生率和病死率也明显低于MDII组（P〈0.01）。结论对危重伴应激性高血糖患者采用胰岛素泵治疗,能有效控制高血糖,降低病死率,改善预后。

Clinical observation on insulin pump therapy for stress hyperglycemia in critically ill patients

Objective To explore the clinical effects of insulin pump therapy for stress hyperglycemia in critically ill patients. Methods One hundred and twelve critically ill patients with stress hyperglycemia were randomly divided into continuous subcutaneous insulin infusion (CSII) groupand multiple daily insulin injection (MDII) group, each group of 56 cases. Both groups were treated with insulin pump, in addition, add with CSII and MDII treatment respectively, in order to maintain blood glucose between 6.1～8.3 mmol/L. Results The blood glucose time, the daily of insulin, after mark blood sugar level and the length of time the were compared between the two groups, the difference all had statistical significance (P < 0.01). The CSII group was higher than the MDII group. The hypoglycemia incidence rate and death rate in CSII group were lower significantly than those in MDII group (P < 0.01). Conclusion Insulin pump therapy for critically ill patients with stress hyperglycemia can effectively control hyperglycemia, decrease death rate and improve prognosis.