摘要
目的探讨胰岛素强化治疗在腹部手术患者肠外营养中的应用效果。方法选取腹部外科手术后应用1周以上完全肠外营养的应激性高血糖患者50例，随机数字表法将患者分为对照组25例和观察组25例，对照组采取常规胰岛素治疗（血糖目标值10．0—11．1mmol／L），治疗组采取胰岛素强化治疗（血糖目标值7．8-10．0mmol／L）。观察对比两组血糖控制达标时间、住院时间及住院费用，同时记录其并发症发生情况。结果治疗组血糖控制达标时间为（5．16±1．25）d，住院时间为（7．69±2．14）d，均短于对照组，观察组住院费用为（1045．16±114．17）元，低于对照组的（2217．18±242．18）元，差异均有统计学意义（t=6．460，6．270，14．499，均P〈0．05）；治疗组并发症发生率8．00％，明显低于对照组的28．00％，差异有统计学意义（χ^2=13．550，P〈0．05）；治疗组病死率为4．00％，与对照组的8．00％比较，差异无统计学意义（χ^2=1．418，P=0．233）。结论采取胰岛素强化治疗可有效控制腹部手术后非糖尿病危重患者的血糖水平，同时能降低并发症发生率，值得推荐。
Objective To investigate the effect of intensive insulin therapy in parenteral nutrition for patients with abdominal operation. Methods 50 patients with 1 week or more complete intestinal nutrition after abdominal surgery and parenteral nutrition stress hyperglycemia were selected and randomly divided into control group （25 cases） and treatment group （ 25 cases ）. The control group adopted conventional insulin treatment （ 10.0 - 11. 1 mmol/L blood glucose target value ） , the treatment group adopted intensive insulin treatment （ 7.8 - 10.0 mmol/L blood glucose target）. The blood glucose time ,hospitalization time and cost were compared between the two groups ,and the occurrence of complications was recorded. Results In the treatment group, the blood sugar control standard time was （5.16 ± 1.25） d, hospitalization time was （7.69 ± 2.14 ） d, which were shorter than those in the control group, the hospitalization expense in the treatment group was （1 045.16 ±114.17）yuan,which was lower than（2 217.18 ± 242.18）yuan of the control group, the differences were statistically significant（ t = 6. 460,6. 270,14. 499, all P 〈 0. 05 ）. The incidence rate of complications of the treatment group was 8.00%, which was significantly lower than 28.00% of the control group ,the difference was statistically significant （χ^2= 13. 550 ,P 〈 0.05 ）. The mortality rate of the treatment group was 4.00% ,which of the control group was 8.00% ,the difference was not statistically significant between the two groups （ χ^2= 1. 418,P = 0. 233 ）. Conclusion Intensive insulin therapy can effectively control the blood glucose level in patients with non diabetes after abdominal operation, and can reduce the incidence of complications, it is worthy of recommending.
作者
姜继华
刘香兰
余献梅
Jiang Jihua Liu Xianglan Yu Xianmei.(Department of Hepatobiliary Surgery, the People＇s Hospital of Qazhou, Quzhou, Zhefiang 324000, China Department of Endocrinology, the People＇s Hospital of Quzhou, Qazhou, Zhejiang 324000, China Department of Endocrinology ,the People＇s Hospital of Qujiang District, Quzhou , Zhejiang 324000, China)
出处
《中国基层医药》
CAS
2017年第5期668-672,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省衢州市科技计划项目（2015N1009795）
关键词
外科手术
腹部
肠外营养
胰岛素
高血糖
Surgical Procedures,Operative
Abdomen
Parenteral nutrition
Insulin
Hyperglycemia
