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目的:观察甘精胰岛素联合门冬胰岛素皮下注射控制2型糖尿病围术期血糖的效果及安全性。方法:选择围术期糖尿病68例,随机分为观察组和对照组各34例。观察组采用甘精胰岛素皮下注射,每天1次;门冬胰岛素每天三餐前皮下注射各1次。对照组采用精蛋白锌合成胰岛素联合三餐前门冬胰岛素皮下注射。观察并比较两组治疗后第1天、3天、5天空腹血糖、早餐后2h血糖、睡前血糖水平,以及血糖达标时间、低血糖发作次数、平均住院时间。结果:治疗后第1天、3天观察组空腹血糖水平显著低于对照组(P<0.05),第5天两组空腹血糖水平差异不显著(P>0.05);两组治疗后第1天、3天、5天餐后2h血糖、睡前血糖水平均差异不显著(P>0.05)。观察组血糖达标及平均住院时间均显著或非常显著短于对照组(P<0.05,P<0.01)。观察组围术期低血糖反应发生率8.8%,非常显著低于对照组的29.4%(P<0.01)。结论:甘精胰岛素联合门冬胰岛素皮下注射控制糖尿病患者围术期血糖,不仅血糖水平控制满意,且低血糖反应发生率低,更安全。
Objective: To observe the effect and safety of glargine combined with aspart insulin subcutaneous injection in controlling perioperative blood glucose in type 2 diabetic patients. Methods: 68 cases of perioperative diabetes mellitus were randomly divided into observation group and control group, 34 cases each. The observation group was injected subcutaneously with insulin glargine once daily. Insulin aspart was injected subcutaneously once a day for three times a day. The control group using protamine zinc combined insulin three meals before aspart insulin subcutaneous injection. Fasting blood glucose, fasting blood glucose at 2h after breakfast, blood glucose level at bedtime, blood glucose level, hypoglycemic episodes and average hospital stay were observed and compared on the 1st, 3rd and 5th day after treatment. Results: On the first day and the third day after treatment, the fasting blood glucose level in the observation group was significantly lower than that in the control group (P <0.05). On the fifth day, the fasting blood glucose level was not significantly different between the two groups (P> 0.05) , 3 days, 5 days postprandial blood glucose 2h, before going to bed blood glucose levels were not significantly different (P> 0.05). Observation group blood glucose compliance and average length of stay were significantly shorter or significantly shorter than the control group (P <0.05, P <0.01). The incidence of perioperative hypoglycemia in the observation group was 8.8%, which was significantly lower than that in the control group (29.4%, P <0.01). Conclusion: Glargine and insulin aspart insulin subcutaneous injection to control perioperative blood glucose in patients with diabetes, not only satisfactory blood glucose control, and low incidence of hypoglycemia, more secure.