胰岛素强化治疗对多发伤伴应激性糖尿病患者相关指标的影响

发布时间：2018-09-04 05:36

【摘要】：目的:探讨胰岛素强化治疗对多发伤伴应激性糖尿病患者相关指标的影响。方法:82例多发伤伴应激性糖尿病患者随机分为观察组和对照组,每组41例。两组患者均结合创伤情况进行针对性处理和常规治疗。在此基础上,观察组患者给予生物合成人胰岛素注射液,微量泵滴注,滴速为1~2 IU/h,并根据实时血糖值调节胰岛素微量泵的滴速;对照组患者给予盐酸二甲双胍片起始剂量0.5 g,每日2次,随餐服用,根据患者血糖监测结果适当增加剂量至1 g,每日2次。两组均连续治疗10 d。观察两组患者治疗前后血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、IL-6、平均血糖值,局部感染、脓毒症和全身炎症反应综合征等并发症发生情况及不良反应发生情况。结果:治疗后,两组患者血清CRP、TNF-α、IL-1、IL-6、平均血糖值水平均显著低于同组治疗前,且5、10 d后观察组患者血清CRP、IL-1、IL-6水平和1、5、10 d后TNF-α、平均血糖值均显著低于对照组同期,差异均有统计学意义(P0.05)。观察组患者并发症总发生率显著低于对照组,差异有统计学意义(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,胰岛素强化治疗多发伤伴应激性糖尿病能够更加有效地降低患者血糖和炎症因子水平,防止多发伤后并发症的发生,且不增加不良反应的发生。
[Abstract]:Objective: to investigate the effect of intensive insulin therapy on the related indexes of multiple injury patients with stress diabetes mellitus. Methods 82 patients with multiple injury and stress diabetes were randomly divided into observation group and control group with 41 cases in each group. The patients in both groups were treated with specific treatment and routine treatment combined with trauma. On this basis, the patients in the observation group were treated with biosynthetic human insulin injection and micropump infusion at a drip rate of 1 ~ 2 IU/h, and the droplet velocity of the insulin micropump was adjusted according to the real-time blood glucose value. Patients in the control group were given metformin hydrochloride at the initial dose of 0.5 g, twice a day, with meals. According to the results of blood glucose monitoring, the dosage was increased to 1 g, twice a day. Both groups were treated continuously for 10 days. Serum C-reactive protein (CRP), tumor necrosis factor 伪 (TNF- 伪), interleukin-1 (IL-1), interleukin-6 (IL-6), mean blood glucose, local infection, sepsis and systemic inflammatory response syndrome were observed before and after treatment. Results: after treatment, the serum levels of CRP,TNF- 伪 IL-1hIL-6 and average blood glucose in the two groups were significantly lower than those in the same group before treatment, and the levels of serum CRP,IL-1,IL-6 and TNF- 伪 in the observation group were significantly lower than those in the control group 10 days after treatment (P0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (P0.05). No significant adverse reactions occurred during treatment in both groups. Conclusion: on the basis of routine treatment, intensive insulin therapy for multiple injuries with stress diabetes can more effectively reduce the level of blood glucose and inflammatory factors, prevent the occurrence of complications after multiple injuries, and do not increase the occurrence of adverse reactions.
【作者单位】：永康市第一人民医院重症医学科;
【分类号】：R587.1

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