中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2008年
6期
456-458
,共3页
崔京男%姜今华%许敢峰%裴海成
崔京男%薑今華%許敢峰%裴海成
최경남%강금화%허감봉%배해성
糖尿病,2型%骨折%胰岛素%手术期间%胰岛素输注系统%高血糖症%低血糖症
糖尿病,2型%骨摺%胰島素%手術期間%胰島素輸註繫統%高血糖癥%低血糖癥
당뇨병,2형%골절%이도소%수술기간%이도소수주계통%고혈당증%저혈당증
Diabetes mellitus,type 2%Fractures%Insulin%Intraoperative period%Insulin infusion systems%Hyperglycemia%Hypoglycemia
目的 探讨骨折合并2型糖尿病患者围手术期控制血糖的最佳方法.方法 2型糖尿病骨折患者随机分为胰岛素泵治疗组(CSII组,n=10,门冬胰岛素)、甘精胰岛素治疗组(GA组,n=20,门冬胰岛素+甘精胰岛素)与重组人胰岛素N治疗组(NA组,n=20,门冬胰岛素+重组人胰岛素N),比较3组患者空腹和餐后2 h血糖、血糖波动、所需胰岛素剂量、血糖达标时间、低血糖和黎明现象及感染发生例数、平均拆线时间、平均住院天数.结果 治疗后CSII组、GA组和NA组空腹血糖[(6.32±1.18)、(6.25±0.88)、(7.44±1.36)mmol/L]和餐后2 h血糖[(7.72±1.53)、(7.32±1.17)、(8.52±0.76)mmol/L]、所需胰岛素剂量[(35.40±1.60)、(36.20±0.80)、(40.50±2.40)IU]、血糖波动状况、血糖达标时间、低血糖和黎明现象及感染发生率、平均拆线时间、平均住院时间各项指标相比较,CSII、GA组明显低于NA组(P<0.05),而CSII组与GA组间无显著差异,但GA组更经济、实用.结论 胰岛素泵持续皮下注射和甘精胰岛素联合门冬胰岛素方案能迅速、有效、安全、平稳地控制全天血糖,是2型糖尿病骨折患者围手术期控制血糖强化治疗的首选方案.
目的 探討骨摺閤併2型糖尿病患者圍手術期控製血糖的最佳方法.方法 2型糖尿病骨摺患者隨機分為胰島素泵治療組(CSII組,n=10,門鼕胰島素)、甘精胰島素治療組(GA組,n=20,門鼕胰島素+甘精胰島素)與重組人胰島素N治療組(NA組,n=20,門鼕胰島素+重組人胰島素N),比較3組患者空腹和餐後2 h血糖、血糖波動、所需胰島素劑量、血糖達標時間、低血糖和黎明現象及感染髮生例數、平均拆線時間、平均住院天數.結果 治療後CSII組、GA組和NA組空腹血糖[(6.32±1.18)、(6.25±0.88)、(7.44±1.36)mmol/L]和餐後2 h血糖[(7.72±1.53)、(7.32±1.17)、(8.52±0.76)mmol/L]、所需胰島素劑量[(35.40±1.60)、(36.20±0.80)、(40.50±2.40)IU]、血糖波動狀況、血糖達標時間、低血糖和黎明現象及感染髮生率、平均拆線時間、平均住院時間各項指標相比較,CSII、GA組明顯低于NA組(P<0.05),而CSII組與GA組間無顯著差異,但GA組更經濟、實用.結論 胰島素泵持續皮下註射和甘精胰島素聯閤門鼕胰島素方案能迅速、有效、安全、平穩地控製全天血糖,是2型糖尿病骨摺患者圍手術期控製血糖彊化治療的首選方案.
목적 탐토골절합병2형당뇨병환자위수술기공제혈당적최가방법.방법 2형당뇨병골절환자수궤분위이도소빙치료조(CSII조,n=10,문동이도소)、감정이도소치료조(GA조,n=20,문동이도소+감정이도소)여중조인이도소N치료조(NA조,n=20,문동이도소+중조인이도소N),비교3조환자공복화찬후2 h혈당、혈당파동、소수이도소제량、혈당체표시간、저혈당화려명현상급감염발생례수、평균탁선시간、평균주원천수.결과 치료후CSII조、GA조화NA조공복혈당[(6.32±1.18)、(6.25±0.88)、(7.44±1.36)mmol/L]화찬후2 h혈당[(7.72±1.53)、(7.32±1.17)、(8.52±0.76)mmol/L]、소수이도소제량[(35.40±1.60)、(36.20±0.80)、(40.50±2.40)IU]、혈당파동상황、혈당체표시간、저혈당화려명현상급감염발생솔、평균탁선시간、평균주원시간각항지표상비교,CSII、GA조명현저우NA조(P<0.05),이CSII조여GA조간무현저차이,단GA조경경제、실용.결론 이도소빙지속피하주사화감정이도소연합문동이도소방안능신속、유효、안전、평은지공제전천혈당,시2형당뇨병골절환자위수술기공제혈당강화치료적수선방안.
Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.
