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目的探讨血糖控制对老年糖尿病合并急性胆囊炎患者内科治疗时感染控制以及预后的影响。方法将58例老年2型糖尿病合并急性胆囊炎患者随机分为研究组和对照组,在抗感染、补液等综合治疗同时,研究组采用胰岛素强化治疗,对照组普通降糖治疗,在治疗3 d和7 d后观察体温、腹痛、血糖、中性粒白细胞计数、C反应蛋白水平,比较两组治疗效果。结果治疗3 d和7 d后,研究组和对照组血糖分别为(7.0±2.3)mmol/L、(9.2±3.7)mmol/L和(6.5±1.9)mmol/L、(9.8±2.6)mmol/L,餐后2小时血糖分别为(10.8±2.5)mmol/L、(12.5±3.4)mmol/L和(8.1±1.8)mmol/L、(11.9±2.7)mmol/L;中性粒白细胞计数分别为(9.5±2.3)×109/L、(10.8±3.9)×109/L和(6.4±1.2)×109/L、(8.7±2.9)×109/L;C反应蛋白分别为(46.1±3.9)mg/L、(59.6±3.9)mg/L和(8.8±2.7)mg/L、(27.3±6.2)mg/L;研究组和对照组治愈率分别为68.9%和20.6%,有效率为89.6%和55.2%。结论强化血糖控制有利于老年糖尿病合并急性胆囊炎患者的感染控制,同时明显提高非手术治疗治愈率和临床疗效。
Objective To investigate the effect of glycemic control on infection control and prognosis in elderly patients with diabetes mellitus complicated with acute cholecystitis during medical treatment. Methods Fifty-eight elderly patients with type 2 diabetes mellitus complicated with acute cholecystitis were randomly divided into study group and control group. In combination with anti-infective and rehydration therapy, the study group was given insulin-intensive therapy and the control group received general hypoglycemic therapy. After 3 days of treatment, After 7 days, the body temperature, abdominal pain, blood glucose, neutrophilic granulocyte count and C-reactive protein level were observed. The therapeutic effect was compared between the two groups. Results After 3 d and 7 d of treatment, the blood glucose of the study group and the control group were (7.0 ± 2.3) mmol / L, (9.2 ± 3.7) mmol / L and (6.5 ± 1.9) mmol / L, / L, respectively. The blood glucose levels at 2 hours after meal were (10.8 ± 2.5) mmol / L, (12.5 ± 3.4) mmol / L and (8.1 ± 1.8) mmol / L The counts were (9.5 ± 2.3) × 109 / L, (10.8 ± 3.9) × 109 / L and (6.4 ± 1.2) × 109 / L respectively ± 3.9) mg / L, (59.6 ± 3.9) mg / L and (8.8 ± 2.7) mg / L and (27.3 ± 6.2) mg / L respectively.The cure rates of the study group and the control group were 68.9% and 20.6% Efficiency is 89.6% and 55.2%. Conclusion Intensive glycemic control is beneficial to infection control in elderly diabetic patients with acute cholecystitis and significantly improves the cure rate and clinical efficacy of non-surgical treatment.