参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖的临床观察

发布时间：2018-02-27 00:09

  本文关键词： 参麦注射液 胰岛素 脓毒症 应激性高血糖 死亡率 急性生理与慢性健康评分　出处：《中国药房》2016年24期 　论文类型：期刊论文

【摘要】：目的:观察参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖的疗效。方法:回顾性收集156例脓毒症且确诊为应激性高血糖患者资料,按用药不同分为对照组(78例)和观察组(78例)。所有患者及时确定病原菌并给予相应的抗感染治疗、改善通气状态、给予充分液体复苏支持、适当给予免疫治疗和营养支持等常规治疗;在此基础上,对照组患者按不同的血糖水平给予不同剂量的胰岛素[1 U/ml,静脉微量泵入,速度为0.1 U/(kg·h)];观察组患者在对照组治疗的基础上加用参脉注射液40 ml,加入胰岛素混合溶液中,静脉微量泵入。观察两组患者终点事件、血糖达标时间、胰岛素总用量、基础指标[急性生理与慢性健康(24APACHE-Ⅱ)评分、机械通气时间、ICU住院天数、低血糖发生例次]及不良反应发生情况。结果:观察组患者终点事件总发生率显著低于对照组,血糖达标时间显著短于对照组,胰岛素总用量显著少于对照组,机械通气时间显著短于对照组,ICU住院时间显著少于对照组,差异均有统计学意义(P0.05);治疗前,两组患者24 APACHE-Ⅱ评分差异无统计学意义(P0.05);治疗后,两组患者24 APACHE-Ⅱ评分显著降低,且观察组低于对照组,差异均有统计学意义(P0.05)。两组患者治疗期间均未见明显不良反应发生。结论:在常规治疗的基础上,参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖疗效较好,能减少达标血糖所用时间胰岛素总用量,降低终点事件总发生率和24 APACHE-Ⅱ评分,缩短机械通气时间、减少ICU住院天数,且安全性较好。
[Abstract]:Objective: to observe the effect of Shenmai injection combined with insulin intensive therapy on stress hyperglycemia in sepsis. Methods: 156 patients with sepsis and diagnosed as stress hyperglycemia were collected retrospectively. The patients were divided into control group (n = 78) and observation group (n = 78) according to their medication. All the patients were given appropriate anti-infective therapy, improved ventilation and adequate fluid resuscitation support. The patients in the control group were given different doses of insulin according to different levels of blood glucose [1 U / ml, intravenous micropump,] on the basis of appropriate routine therapy such as immunotherapy and nutritional support. The patients in the observation group were treated with Shenmai injection 40 ml on the basis of the treatment in the control group. The patients in the observation group were injected with insulin mixed solution and pumped into the vein microinjection. The endpoint events, the time of blood glucose reaching the standard, and the total amount of insulin were observed in the two groups. Basic index [acute physiology and chronic health 24APACHE- 鈪，

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