中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
4期
14-17
,共4页
胰岛素%心力衰竭,充血性%肺部感染%高血糖
胰島素%心力衰竭,充血性%肺部感染%高血糖
이도소%심력쇠갈,충혈성%폐부감염%고혈당
Insulin%Heart failure,congestive%Lung infection%Hyperglycemia
目的 研究胰岛素强化疗法(IIT)在严重心力衰竭合并肺部感染高血糖患者中的临床疗效.方法 回顾性分析2009年1月至2012年8月在ICU住院治疗的严重心力衰竭合并肺部感染高血糖患者104例,其中胰岛素常规治疗者48例(对照组),IIT治疗者56例(观察组).观察并比较两组各时间点血糖变化情况及抗生素使用时间、肺部感染控制情况、病死率.结果 观察组和对照组治疗前血糖分别为(15.8±4.3),(15.3±5.1) mmol/L,两组比较差异无统计学意义(P＞0.05).观察组治疗后24、48、72 h和治疗后1周血糖分别为(8.3±2.1),(8.0±1.2),(7.9±1.3),(7.9±1.1) mmol/L,对照组分别为(12.5±3.2),(11.7±2.1),(11.3±1.5),(11.2±1.7) mmol/L,两组患者血糖均下降,而观察组各时间点血糖与对照组相比下降更加明显,差异有统计学意义(P＜0.01).观察组患者抗生素使用时间为(14.3±2.5)d,显著少于对照组的(20.1±3.2)d,差异有统计学意义(t=10.368,P＜0.01).观察组肺部感染治疗的总有效率为87.5％(49/56),显著高于对照组的68.8％(33/48),差异有统计学意义(x2=5.448,P＜0.05).观察组病死率为8.9％(5/56),显著低于对照组的22.9％(11/48),差异有统计学意义(x2=6.423,P＜0.05).结论 将IIT用于严重心力衰竭合并肺部感染高血糖患者的治疗中,可显著改善患者临床预后,降低病死率,值得在临床中推广应用.
目的 研究胰島素彊化療法(IIT)在嚴重心力衰竭閤併肺部感染高血糖患者中的臨床療效.方法 迴顧性分析2009年1月至2012年8月在ICU住院治療的嚴重心力衰竭閤併肺部感染高血糖患者104例,其中胰島素常規治療者48例(對照組),IIT治療者56例(觀察組).觀察併比較兩組各時間點血糖變化情況及抗生素使用時間、肺部感染控製情況、病死率.結果 觀察組和對照組治療前血糖分彆為(15.8±4.3),(15.3±5.1) mmol/L,兩組比較差異無統計學意義(P＞0.05).觀察組治療後24、48、72 h和治療後1週血糖分彆為(8.3±2.1),(8.0±1.2),(7.9±1.3),(7.9±1.1) mmol/L,對照組分彆為(12.5±3.2),(11.7±2.1),(11.3±1.5),(11.2±1.7) mmol/L,兩組患者血糖均下降,而觀察組各時間點血糖與對照組相比下降更加明顯,差異有統計學意義(P＜0.01).觀察組患者抗生素使用時間為(14.3±2.5)d,顯著少于對照組的(20.1±3.2)d,差異有統計學意義(t=10.368,P＜0.01).觀察組肺部感染治療的總有效率為87.5％(49/56),顯著高于對照組的68.8％(33/48),差異有統計學意義(x2=5.448,P＜0.05).觀察組病死率為8.9％(5/56),顯著低于對照組的22.9％(11/48),差異有統計學意義(x2=6.423,P＜0.05).結論 將IIT用于嚴重心力衰竭閤併肺部感染高血糖患者的治療中,可顯著改善患者臨床預後,降低病死率,值得在臨床中推廣應用.
목적 연구이도소강화요법(IIT)재엄중심력쇠갈합병폐부감염고혈당환자중적림상료효.방법 회고성분석2009년1월지2012년8월재ICU주원치료적엄중심력쇠갈합병폐부감염고혈당환자104례,기중이도소상규치료자48례(대조조),IIT치료자56례(관찰조).관찰병비교량조각시간점혈당변화정황급항생소사용시간、폐부감염공제정황、병사솔.결과 관찰조화대조조치료전혈당분별위(15.8±4.3),(15.3±5.1) mmol/L,량조비교차이무통계학의의(P＞0.05).관찰조치료후24、48、72 h화치료후1주혈당분별위(8.3±2.1),(8.0±1.2),(7.9±1.3),(7.9±1.1) mmol/L,대조조분별위(12.5±3.2),(11.7±2.1),(11.3±1.5),(11.2±1.7) mmol/L,량조환자혈당균하강,이관찰조각시간점혈당여대조조상비하강경가명현,차이유통계학의의(P＜0.01).관찰조환자항생소사용시간위(14.3±2.5)d,현저소우대조조적(20.1±3.2)d,차이유통계학의의(t=10.368,P＜0.01).관찰조폐부감염치료적총유효솔위87.5％(49/56),현저고우대조조적68.8％(33/48),차이유통계학의의(x2=5.448,P＜0.05).관찰조병사솔위8.9％(5/56),현저저우대조조적22.9％(11/48),차이유통계학의의(x2=6.423,P＜0.05).결론 장IIT용우엄중심력쇠갈합병폐부감염고혈당환자적치료중,가현저개선환자림상예후,강저병사솔,치득재림상중추엄응용.
Objective To study the clinical efficacy of intensive insulin therapy (IIT) on patients with severe heart failure,pulmonary infection and hyperglycemia.Methods A retrospective analysis was studied on 104 patients with severe heart failure,pulmonary infection and hyperglycemia from January 2009 to August 2012,and 48 cases were treated by insulin conventional treatment (control group),while 56 cases were treated by IIT treatment (observation group).The blood glucose changes at each time and time of antibiotic using,pulmonary infection control situation and mortality rate between the two groups were observed and compared.Results The blood glucose before treatment in observation group and control group were (15.8 ± 4.3) and (15.3 ± 5.1) mmol/L,and there was no statistical difference (P ＞ 0.05).The blood glucose levels at 24,48,72 h and 1 week after treatment in observation group were (8.3 ± 2.1),(8.0 ± 1.2),(7.9 ± 1.3) and (7.9 ± 1.1) mmol/L,in control group were (12.5 ± 3.2),(11.7 ± 2.1),(11.3 ± 1.5) and (11.2 ± 1.7) mmol/L.The blood glucose levels after treatment in the two groups were significantly lower than those before treatment,but in observation group were significantly lower than those in control group,and there were statistical differences (P ＜0.01).The time of antibiotic using in observation group was significantly shorter than that in control group [(14.3 ± 2.5) d vs.(20.1 ± 3.2) d],and there was statistical difference(t =10.368,P ＜ 0.01).The total effective rate of pulmonary infection in observation group was significantly higher than that in control group [87.5％(49/56) vs.68.8％(33/48)],and there was statistical difference (x2 =5.448,P ＜ 0.05).The mortality rate in observation group was significantly lower than that in control group [8.9％ (5/56) vs.22.9％ (11/48)],and there was statistical difference (x2 =6.423,P ＜ 0.05).Conclusion The IIT used in the treatment of patients with severe heart failure,pulmonary infection and hyperglycemia can significantly improve the prognosis of patients and reduce mortality rate,which is worthy of clinical application.
