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[目的]比较应用胰岛素泵持续皮下胰岛素输注法(continuous subcutaneous insulin injection,CSII)与多次皮下胰岛素注射法(multiple subcutaneous insulin injection,MSII)对2型糖尿病(T2DM)患者关节置换围手术期的治疗效果,探讨最佳血糖控制方法。[方法]回顾性分析2006年6月~2012年7月接受髋/膝关节置换手术资料完整的60例老年2型糖尿病患者,围手术期均采用胰岛素控制血糖,其中有31例采用多次皮下注射胰岛素(MSII)法,29例经胰岛素泵持续皮下输注(CSII)胰岛素治疗。观察2组入院时血糖水平、给药后的血糖水平、血糖达标时间、低血糖发生率、手术切口愈合率、手术切口延迟愈合率、手术切口感染率等指标。[结果]两组均可有效控制血糖(P<0.01),治疗后CSII组餐后2 h血糖优于MSII组(P<0.01),CSII组血糖达标时间、低血糖及术后并发症发生率、住院时间均少于MSII组(P<0.01)。[结论]T2DM关节置换围手术期应用胰岛素泵控制血糖安全有效,并可明显缩短住院时间。
[Objective] To compare the effects of continuous subcutaneous insulin injection (CSII) and multiple subcutaneous insulin injection (MSII) on patients with type 2 diabetes mellitus (T2DM) during perioperative period Therapeutic effect, to explore the best method of glycemic control. [Methods] A total of 60 elderly patients with type 2 diabetes mellitus who underwent hip arthroplasty between June 2006 and July 2012 were retrospectively analyzed. Insulin was used during the perioperative period to control blood glucose. Among them, 31 patients underwent multiple subcutaneous Injecting insulin (MSII), 29 patients underwent continuous subcutaneous insulin infusion (CSII) insulin treatment. The blood glucose level, blood glucose level after administration, blood glucose level, the incidence of hypoglycemia, the healing rate of surgical incision, the delayed healing rate of surgical incision and the incision infection rate were observed. [Results] The blood glucose of both groups was significantly lower than that of the MSII group (P <0.01). After 2 weeks of treatment, the blood glucose of CSII group was better than that of the MSII group (P <0.01), and the CSII group’s blood glucose time, hypoglycemia and postoperative complication rate , Less hospital stay than MSII group (P <0.01). [Conclusion] It is safe and effective to use insulin pump to control blood sugar during the perioperative period of T2DM joint replacement and can significantly shorten the length of hospital stay.