摘要
目的糖尿病酮症酸中毒发病急,进展快,严重时可致急性肾衰竭和休克,威胁患者生命安全,临床多用胰岛素治疗。本研究旨在探讨不同胰岛素给药方式对急诊糖尿病酮症酸中毒患者临床症状及血糖的影响。方法选择郑州中康医院2016-03-24-2019-05-16收治的90例糖尿病酮症酸中毒患者为研究对象,按性别、年龄和血糖水平等因素组间匹配的原则分为对照组(45例)和观察组(45例)。两组患者均给予纠正水电解质紊乱、纠正酸碱平衡和补液等常规对症治疗。对照组在此基础上应用小剂量胰岛素静脉持续滴入治疗,观察组在常规治疗基础上给予胰岛素泵皮下输注。比较两组患者疗效、临床症状及血糖水平。结果观察组治疗总有效率为97.78%(44/45),高于对照组的93.33%(42/45),差异无统计学意义,χ2=0.262,P>0.05。观察组pH值恢复时间为(12.13±3.22)h,低于对照组的(17.48±7.59)h,t=4.353,P=0.001;尿酮体恢复时间为(23.92±3.96)h,低于对照组的(35.87±6.21)h,t=10.884,P=0.001;血酮体恢复时间为(24.89±2.05)h,低于对照组的(37.63±2.58)h,t=25.935,P=0.001;胰岛素用量为(61.79±10.32)U,低于对照组的(73.54±12.04)U,t=4.971,P=0.001。观察组血糖达标时间为(4.54±1.33)h,低于对照组的(6.92±2.08)h,t=6.467,P=0.001。观察组低血糖发生率为2.22%(1/45),低于对照组的20.00%(9/45),差异有统计学意义,χ2=7.200,P=0.007。结论对糖尿病酮症酸中毒患者采用胰岛素泵皮下持续输注可缩短pH值恢复时间、尿酮体恢复时间、血酮体恢复时间和血糖达标时间,减少胰岛素使用量,降低低血糖发生率,促进患者转归。
OBJECTIVE Diabetic ketoacidosis is an acute disease with rapid progress.It can cause acute renal failure and shock in severe cases,which threatens the life safety of patients.Insulin therapy is often used in clinic.The purpose of this study was to investigate the effects of different insulin administration methods on clinical symptoms and blood glucose in emergency diabetic ketoacidosis patients.METHODS A total of 90 patients with diabetic ketoacidosis admitted to Zhengzhou Zhongkang Hospital from March 24,2016 to May 16,2019 were selected as the research objects,and they were divided into control group(45 cases)and observation group(45 cases)according to the matching principle of gender,age and blood glucose level.The two groups of patients were given conventional symptomatic treatment such as correcting water electrolyte disorder,correcting acid-base balance and rehydration.On this basis,the control group was treated with continuous intravenous drip of low-dose insulin,and the observation group was given subcutaneous insulin pump infusion on the basis of conventional treatment.The curative effect,clinical symptoms and blood glucose levels of the two groups were compared.RESULTS The total effective rate of the observation group was 97.78%(44/45),which was higher than 93.33%(42/45)of the control group,the difference was not statistically significant,χ~2=0.262,P>0.05.The recovery time of pH value in the observation group was(12.13±3.22)h,which was lower than(17.48±7.59)h in the control group,and the difference was statistically significant(t=4.353,P=0.001).The recovery time of urine ketone body in the observation group was(23.92±3.96)h,which was lower than(35.87±6.21)h in the control group,and the difference was statistically significant(t=10.884,P=0.001).The recovery time of ketosis in the observation group was(24.89±2.05)h,which was lower than(37.63±2.58)h in the control group,the difference was statistically significant,t=25.935,P=0.001.The insulin dosage of the observation group was(61.79±10.32)U,which was lower than that of the control group(73.54±12.04)U,the difference was statistically significant,t=4.971,P=0.001.The time of blood glucose reaching the standard in the observation group was(4.54±1.33)h,which was lower than(6.92±2.08)h in the control group,the difference was statistically significant,t=6.467,P=0.001.The incidence of hypoglycemia in the observation group was 2.22%(1/45),which was lower than 20.00%(9/45)of the control group,the difference was statistically significant(χ~2=7.200,P=0.007).CONCLUSION Continuous subcutaneous infusion of insulin pump for patients with diabetic ketoacidosis can shorten the recovery time of pH value,urine ketone body,blood ketone body and blood glucose,reduce the amount of insulin used,reduce the incidence of hypoglycemia,and promote the prognosis of patients.
作者
牛建朝
张耀辉
NIU Jian-chao;ZHANG Yao-hui(Department of Emergency,Zhengzhou Zhongkang Hospital,Zhengzhou 452370,P.R.China)
出处
《社区医学杂志》
2020年第18期1274-1277,共4页
Journal Of Community Medicine
关键词
糖尿病酮症酸中毒
胰岛素
给药方式
血糖
diabetic ketoacidosis
insulin
mode of administration
blood glucose
