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目的探讨胰岛素泵治疗老年肺结核合并糖尿病患者的临床效果。方法选取2014年8月到2015年7月沈阳市胸科医院收治的74例老年肺结核合并糖尿病患者作为研究对象,按照随机数字表法将其分为观察组与对照组,各37例。两组患者均采用药物四联(乙胺丁醇、利福平、异烟肼、吡嗪酰胺)结合抗结核治疗,同时对照组患者采用胰岛素多次皮下注射(MSⅡ)治疗,观察组患者选择采用胰岛素泵皮下连续注射(CSⅡ)治疗,比较两组患者治疗效果。结果治疗后,观察组患者的空腹血糖、餐后2 h血糖水平均明显低于对照组,差异均有统计学意义(均P<0.05);观察组患者的胰岛素用量明显少于对照组,且治疗后低血糖发生率明显低于对照组,差异均有统计学意义(均P<0.05);观察组患者的肺结核空洞闭合率及肺结核灶显著吸收率均明显高于对照组,差异均有统计学意义(均P<0.05)。结论采用胰岛素泵治疗老年肺结核合并糖尿病,可有效控制血糖水平,降低低血糖发生率,减少胰岛素用量,且可显著提高肺结核病灶吸收率,预后效果良好。
Objective To investigate the clinical effect of insulin pump in elderly patients with pulmonary tuberculosis complicated with diabetes mellitus. Methods A total of 74 elderly patients with pulmonary tuberculosis and diabetes mellitus admitted to Shenyang Chest Hospital from August 2014 to July 2015 were selected as study subjects and divided into observation group and control group according to random number table method, with 37 cases in each group. Patients in both groups were treated with antiplatelet drugs (ethambutol, rifampicin, isoniazid and pyrazinamide) in combination with anti-tuberculosis. Meanwhile, patients in the control group were treated with multiple subcutaneous injections of insulin (MS Ⅱ) and patients in the observation group Subcutaneous injection of insulin pump (CS Ⅱ) was used to treat the patients and the treatment effect was compared between the two groups. Results After treatment, fasting blood glucose and postprandial blood glucose at 2 h in observation group were significantly lower than those in control group (all P <0.05). Insulin consumption in observation group was significantly less than that of control group After treatment, the incidence of hypoglycemia was significantly lower than that of the control group (all P <0.05). The observation group’s pulmonary tuberculosis cavity closure rate and pulmonary tuberculosis lesions were significantly higher than the control group, the differences were statistically Significance (both P <0.05). Conclusion The treatment of senile pulmonary tuberculosis complicated with diabetes by insulin pump can effectively control the blood sugar level, reduce the incidence of hypoglycemia, reduce the dosage of insulin, and can significantly improve the absorption rate of pulmonary tuberculosis, the prognosis is good.