CAJ | 학술논문

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.
목적 탐토수액빙화미량빙연합응용대이십이지장절제술후조기중증환자혈당공제유효성화안전성적영향.방법 장60례이십이지장절제술후조기중증환자수궤분위2조,대조조30례,준의촉안포도당4 g:중성이도소1 U배제함당액체정맥적주,중성이도소50 U가입생리염수50 ml경미량빙정맥주사,근거혈당공제방안조정빙속유지환자혈당재4.4～8.3 mmol/L.실험조30례,이도소불가입함당액체,채용수액빙공제함당액체24 h균속수입,중성이도소50 U가입생리염수50 ml경미량빙안포도당4 g:중성이도소1 U여함당액체경동일조정맥동보정맥주사,이차위기출량,재결합혈당공제방안조정미량빙속유지환자혈당재4.4～8.3 mmol/L.비교2조혈당공제적수평、안전성、유효성급호사공작량.결과 여대조조비교,실험조고혈당지수(highperglycemic index,HGI)화체도파혈당범위적시간명현강저,유지파혈당범위적시간명현연장;준의촉급여50%포도당창구치료적차수명현저우대조조;발생엄중저혈당적차수화호사공작량등방면,2조간비교무현저차이.결론 쌍빙법능개선중증환자혈당공제적유효성급안전성,이호사공작량무명현증가,인차교전통혈당공제방법경위합리.
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.