目的探讨胰岛素不同应用方式在糖尿病酮症酸中毒昏迷治疗中的效果观察。方法 选择2017年1—12月收治的100例糖尿病酮症酸中毒昏迷患者纳入研究,以数字随机分方式划分为研究组与对照组。对照组行胰岛素静脉注射治疗方法,研究组行胰岛素泵持续泵入治疗方法。观察比较两组患者治疗前及治疗后的血糖指标(空腹血糖水平、餐后2h血糖水平),治疗后尿酮转阴时间、血酮转阴时间及血糖达标时间,以及临床疗效。结果 研究组治疗前空腹血糖为(17.45±2.68)mmol/L、餐后2h血糖为(23.78±3.40)mmol/L,与对照组比较差异均无统计学意义(P>0.05);研究组治疗后的空腹血糖为(9.01±2.02)mmol/L、餐后2h血糖为(10.12±2.50)mmol/L,均明显低于对照组(均P<0.05);研究组治疗后的尿酮转阴时间为(46.03±4.20)h、血酮转阴时间为(25.45±3.68)h及血糖达标时间为(11.17±1.86)h,均明显短于对照组(均P<0.05);研究组的治疗总有效率与对照组比较差异无统计学意义(92.0%比88.0%,P>0.05)。结论 在糖尿病酮症酸中毒昏迷治疗中应用胰岛素泵持续泵入治疗方法的效果与胰岛素静脉注射治疗方法相当,但可以更有效控制血糖指标,缩短尿酮、血酮转阴时间以及血糖达标时间。
Objective To investigate the effects of different insulin application methods in the treatment of coma caused by diabetic ketoacidosis. Methods A total of 100 patients with coma caused by diabetic ketoacidosis treated at our hopsital from January to December, 2017 were enrolled in the study. They were randomly divided into a study group and a control group. The control group was treated with insulin intravenous injection, while the study group with continuous infusion of insulin pump. Results Before the treatment, the levels of fasting blood glucose and postprandial blood glucose in the study group were (17.45±2.68) mmol/ L and (23.78±3.40) mmol/L, with no statistical differences from those in the control group (both P > 0.05). After the Treatment, the levels of fasting blood glucose and postprandial blood glucose in the study group were (9.01±2.02) mmol/L and (10.12±2.50) mmol/L, which were lower than those in the control group (P < 0.05). After the treatment, the times for the conversion of ketone in urine and blood as well as the time for blood glucose reaching to the standard were (46.03±4.20) h,(25.45±3.68) h, and (11.17±1.86) h in the study group, which were shorter than those in the control group (all P < 0.05). The total effective rate was higher in the study group than in the control group (92.0% vs. 88.0%), but with no statistical difference (P > 0.05). Conclusion The effect of continuous insulin pump infusion in the treatment of coma caused by diabetic ketoacidosis is statistically different from that of intravenous insulin injection, but it can control blood sugar indicators more effectively, shorten the times to turn urine and blood ketone negative and the time for blood glucose reaching the standard.
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