CAJ | 학술논문

目的：对比观察小剂量胰岛素持续静脉滴注和胰岛素泵持续皮下输注胰岛素两种胰岛素给药方法治疗糖尿病酮症酸中毒（DKA）的临床疗效。方法选择2012年3月~2014年2月我院急诊科收治的糖尿病酮症酸中毒患者60例，用随机数字表法将患者分为观察组和对照组，每组30例。对照组采用小剂量胰岛素持续静脉滴注，观察组采用胰岛素泵持续皮下输注胰岛素，对比观察两组治疗后空腹血糖以及低血糖发生例数、血糖达标时间、尿酮体转阴时间以及胰岛素用量。结果治疗后两组空腹血糖比较差异无统计学意义（P＞0.05）；观察组血糖达标时间和尿酮体转阴时间均短于对照组，差异有统计学意义（P＜0.05）；观察组无低血糖患者发生，对照组共5例患者出现低血糖，两组比较差异有统计学意义（P＜0.05）；治疗后观察组胰岛素用量显著少于对照组，差异有统计学意义（P＜0.05）。结论胰岛素泵持续皮下输注胰岛素治疗更能快速、有效纠正糖尿病酮症酸中毒患者代谢紊乱，降低低血糖发生风险，减少胰岛素用量，临床疗效显著，值得积极推广。
목적：대비관찰소제량이도소지속정맥적주화이도소빙지속피하수주이도소량충이도소급약방법치료당뇨병동증산중독（DKA）적림상료효。방법선택2012년3월~2014년2월아원급진과수치적당뇨병동증산중독환자60례，용수궤수자표법장환자분위관찰조화대조조，매조30례。대조조채용소제량이도소지속정맥적주，관찰조채용이도소빙지속피하수주이도소，대비관찰량조치료후공복혈당이급저혈당발생례수、혈당체표시간、뇨동체전음시간이급이도소용량。결과치료후량조공복혈당비교차이무통계학의의（P＞0.05）；관찰조혈당체표시간화뇨동체전음시간균단우대조조，차이유통계학의의（P＜0.05）；관찰조무저혈당환자발생，대조조공5례환자출현저혈당，량조비교차이유통계학의의（P＜0.05）；치료후관찰조이도소용량현저소우대조조，차이유통계학의의（P＜0.05）。결론이도소빙지속피하수주이도소치료경능쾌속、유효규정당뇨병동증산중독환자대사문란，강저저혈당발생풍험，감소이도소용량，림상료효현저，치득적겁추엄。
Objective To observe the clinical effects betwee small doses of insulin intravenous drip continuously and Insulin pump continuous subcutaneous insulin infusion treated on diabetic ketoacidosis patients. Methods Selected 60 diabetic ketoacidosis patients in our hospital emergency department from March 2012 - February 2014, they were divided into observation group and control group according to the random number table method, 30 cases in each group. Patients in control group were treated with small doses of insulin intravenous drip continuously, while patients in observation group were treated with Insulin pump continuous subcutaneous insulin infusion.Observed the fasting plasma glucose after treatment, The cases of hypoglycemia,the time of blood glucose controlled and urine acetone bodies turned and Insulin dosage. Results There was no significant difference between two groups in fasting plasma glucose after treatment(P > 0.05); the time of blood glucose controlled and urine acetone bodies turned in observation group were much shorter than in control group, the difference was statistically significant(P<0.05);There was no hypoglycemia in observation group, while there were 5 case hypoglycemia in control group, the difference was statistically significant(P<0.05);The Insulin dosage in observation group were much less than in control group,the difference was statistically significant(P<0.05). Conclusion Insulin pump continuous subcutaneous insulin infusion therapy can more quickly and effectively correct metabolic disorder in patients with diabetic ketoacidosis, reduce the risk of hypoglycaemia, reduce the dosage of insulin, the clinical curative effect is distinct, to actively promote.