CAJ | 학술논문

目的探讨强化胰岛素治疗用于老年重症患者的临床效果.方法2005年6月至2007年12月北京同仁医院中心ICU的老年(≥65岁)重症患者,根据目标血糖控制水平分为A组(4.4～6.1 mmol/L)和B组(7.3～8.3 mmol/L),应用计算机管理程序化血糖控制方案控制血糖,记录各组血糖控制情况及预后指标.结果共639例患者入选,A组(n =280)和B组(n=359)平均血糖水平分别为(6.07±0.56) mmol/L和(7.52±0.87) mmol/L,均控制在目标范围内.两组高血糖指数分别为(0.69±0.44) mmol/L和(1.60±0.73) mmol/L (P=O.000)；无低血糖相关不良事件发生.两组的ICU住院天数、机械通气时间、住院费用、ICU死亡率及院内死亡率差异均无统计学意义.结论老年重症患者血糖控制在≤8.3 mmol/L安全、合理、易于操作.
목적탐토강화이도소치료용우노년중증환자적림상효과.방법2005년6월지2007년12월북경동인의원중심ICU적노년(≥65세)중증환자,근거목표혈당공제수평분위A조(4.4～6.1 mmol/L)화B조(7.3～8.3 mmol/L),응용계산궤관리정서화혈당공제방안공제혈당,기록각조혈당공제정황급예후지표.결과공639례환자입선,A조(n =280)화B조(n=359)평균혈당수평분별위(6.07±0.56) mmol/L화(7.52±0.87) mmol/L,균공제재목표범위내.량조고혈당지수분별위(0.69±0.44) mmol/L화(1.60±0.73) mmol/L (P=O.000)；무저혈당상관불량사건발생.량조적ICU주원천수、궤계통기시간、주원비용、ICU사망솔급원내사망솔차이균무통계학의의.결론노년중증환자혈당공제재≤8.3 mmol/L안전、합리、역우조작.
Objective To investigate the effect of intensive insulin therapy in critically ill elderly patients.Methods Elderly patients ( ≥ 65 years) admitted to the ICU of Beijing Tongren Hospital from June 2005 to December 2007 were divided into Group A ( glucose control target was 4.4-6.1mmol/L) and Group B ( glucose control target was 7.3-8.3mmol/L).Blood glucose level was controlled with a computer-assisted glucose control protocoL Results A total of 639 patients were enrolled,of which 280 were in Group A and 359 in Group B.The mean blood glucose level of the 2 groups was (6.07 ± 0.56) mmol/L and (7.52 ± 0.87 ) mmol/L respectively,both within the target ranges.The hyperglycemic index was (0.69±0.44) mmol/L in Group A and ( 1.60 ±0.73) mmol/L in Group B (P =0.000).No hypoglycemia adverse events occurred in either group.No significant differences were observed in the length of stay in ICU,duration of mechanical ventilation,hospitalization expenses,ICU mortality,and hospital mortality of the 2 groups.Conclusion Maintaining the blood glucose level of critically ill elderly patients at ≤8.3 mmol/L is safe and practical.