论文部分内容阅读
目的探讨胰岛素强化治疗对低热量肠外营养支持危重病人并发症及预后的影响。方法随机抽取ICU及我科病房危重病人184例,均衡分为胰岛素强化治疗组(A)和常规治疗组(B组),A组将血糖控制在4.4～6.1mmol/L之间,B组病人血糖>12mmol/L时追加胰岛素,维持在8.3～11.1mmol/L水平。观察两组病人的并发症和死亡率的情况,监测免疫细胞、炎症因子以及胰高血糖素、皮质醇的变化。结果两组病人的死亡率差异无统计学意义(P>0.05),与B组相比,A组发生败血症和需外科手术干预差异有统计学意义(P<0.05),住院天数缩短,CD3、CD4、CD4/CD8、CRP恢复时间变短,同时胰高血糖素、皮质醇水平也降低。结论通过胰岛素强化治疗,实现目标血糖控制,可以降低低热量肠外营养支持危重病人的感染及感染性并发症,临床应用安全可靠。
Objective To investigate the effects of intensive insulin therapy on the complication and prognosis of critically ill patients undergoing parenteral nutrition support. Methods A total of 184 critically ill patients in ICU and our department were randomly divided into insulin intensive treatment group (A) and conventional treatment group (B group). Blood glucose was controlled between 4.4 and 6.1 mmol / L in group A, and patients in group B Blood glucose> 12mmol / L additional insulin, maintained at 8.3 ~ 11.1mmol / L level. Complications and mortality rates were observed in both groups, with changes in immune cells, inflammatory factors, and glucagon and cortisol monitored. Results There was no significant difference in mortality between the two groups (P> 0.05). Compared with group B, sepsis and surgical intervention in group A were statistically significant (P <0.05), hospital stay was shorter, CD3, CD4, CD4 / CD8, CRP recovery time shorter, at the same time glucagon, cortisol levels also decreased. Conclusions Intensive insulin therapy can achieve the goal of glycemic control, which can reduce the infection and infectious complications of critically ill patients undergoing parenteral nutrition support. The clinical application is safe and reliable.