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目的研究实时动态血糖监测系统(DGMSReal-Time)联合胰岛素泵(CSII)治疗在胃转流手术(GBP)围手术期的应用。方法将44例符合GBP条件的T2DM患者随机分为试验组和对照组,试验组20例采用DGMS?Real-Time联合CSII治疗,对照组24例采用指尖血糖监测联合胰岛素持续静脉滴注及皮下胰岛素注射治疗。连续观察整个围手术期血糖水平、全天胰岛素用量、低血糖发生率、高血糖发生率。结果 (1)试验组术前、术中及术后各时间点平均血糖均低于对照组,差异有统计学意义(P<0.05或P<0.01)。(2)试验组整个围手术期平均血糖、24h胰岛素用量均低于对照组,差异有统计学意义(P<0.05)。(3)试验组低血糖发生率、高血糖发生率均低于对照组,差异有统计学意义(P<0.05)。结论胃转流手术围手术期,DGMSReal-Time联合CSII治疗优于指尖血糖监测联合胰岛素持续静脉滴注及皮下胰岛素注射治疗。
Objective To study the application of DGMS Real-Time combined with insulin pump (CSII) in the perioperative period of gastric bypass surgery (GBP). Methods Forty-four T2DM patients with GBP were randomly divided into experimental group and control group. In the experimental group, 20 cases were treated with DGMS Real-Time combined with CSII. In the control group, 24 cases were treated with fingertip blood glucose monitoring and continuous insulin infusion and subcutaneous Insulin injection therapy. Continuous observation of the perioperative blood glucose levels, the amount of insulin throughout the day, the incidence of hypoglycemia, the incidence of hyperglycemia. Results (1) The mean blood glucose of the experimental group before operation, during the operation and after operation were lower than those of the control group, the difference was statistically significant (P <0.05 or P <0.01). (2) The mean perioperative blood glucose and 24h insulin in the experimental group were all lower than those in the control group, with significant difference (P <0.05). (3) The incidence of hypoglycemia and hyperglycemia in the experimental group were lower than those in the control group, the difference was statistically significant (P <0.05). Conclusions Perioperative period of gastric bypass surgery, DGMS Real-Time combined with CSII treatment is superior to fingertip blood glucose monitoring combined with continuous insulin infusion and subcutaneous insulin injection.