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目的探讨早期强化胰岛素治疗老年危重病患者应激性高血糖的临床疗效。方法采用前瞻,随机,对照临床试验,将72例老年(>65岁)危重病患者分为常规组(n=36)和胰岛素强化治疗组(n=36)。常规治疗是指当患者血糖≥12·0mmol/L时,控制其血糖水平<12mmol/L;强化治疗组则控制患者血糖水平4～10mmol/L,直到患者转出ICU或死亡,两组其余临床治疗相同。分析两组病例预后指标之间的差异性。结果两组存活病例住ICU时间、感染发生率、病死率方面差异有统计学意义(P<0·05)。结论对于发生应激性高血糖的老年危重病患者,早期强化胰岛素治疗能更有效、更及时控制血糖,并显著改善临床疗效。
Objective To investigate the clinical effects of early intensive insulin therapy on stress hyperglycemia in elderly critically ill patients. Methods 72 cases of elderly (> 65 years) critically ill patients were divided into routine group (n = 36) and intensive insulin treatment group (n = 36) by prospective, randomized, controlled clinical trial. Routine treatment refers to the control of blood glucose level <12mmol / L when the patient’s blood glucose ≥ 12 · 0mmol / L; the intensive treatment group controls the patient’s blood glucose level 4 ~ 10mmol / L, until the patient is out of the ICU or died, The same treatment. Analysis of the differences between the two groups of prognostic indicators. Results There were significant differences in ICU time, infection rate and mortality between survivors in the two groups (P <0.05). Conclusion For elderly critically ill patients with stress hyperglycemia, early intensive insulin therapy can be more effective, more timely control of blood glucose, and significantly improve the clinical efficacy.