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目的探讨中老年糖尿病白内障患者围手术期采用两种胰岛素治疗方案的临床疗效。方法 42例住院的2型糖尿病白内障患者随机分为二组,一组用胰岛素泵持续皮下胰岛素注射(CSⅡ),另一组为每日多次注射胰岛素(MSⅡ)。观察两组胰岛素用量、待手术时间、住院时间等,分析两种治疗方案对控制空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血清蛋白(GSP)的效果。结果术前人均日胰岛素用量CSⅡ组(36.40±6.00)U,MSⅡ组(46.80±9.97)U;待手术天数CSⅡ组(3.20±0.90)d,MSⅡ组(8.40±2.83)d;住院天数CSⅡ组(9.80±3.30)d,MSⅡ组(14.80±6.62)d;低血糖发生率CSⅡ组为8.70%,MSⅡ组26.32%。治疗后CSⅡ组FPG(5.12±0.63)mmol/L,MSⅡ组(6.26±0.91)mmol/L;CSⅡ组2 h PG(7.41±0.83)mmol/L,MSⅡ组(9.22±1.03)mmol/L。两组差异均有统计学意义(均P<0.01)。结论 CSⅡ较MSⅡ能缩短待手术天数和住院天数,减少胰岛素的用量,低血糖发生率较低,能更平稳、更迅速地控制血糖。
Objective To investigate the clinical efficacy of two kinds of insulin therapy in perioperative period in middle-aged and elderly patients with diabetic cataract. Methods 42 hospitalized type 2 diabetic cataract patients were randomly divided into two groups: one was continuous insulin infusion (CS Ⅱ) with insulin pump and the other was multiple injections of insulin daily (MS Ⅱ). The effects of two treatment regimens on the control of fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), and glycosylated serum protein (GSP) were observed in two groups of insulin dosage, duration of surgery and length of stay. Results The preoperative per capita insulin dosage of CSⅡ group was (36.40 ± 6.00) U, MSⅡgroup (46.80 ± 9.97) U, CSⅡgroup (3.20 ± 0.90) d, MSⅡgroup (8.40 ± 2.83) d, (9.80 ± 3.30) d, MSⅡ (14.80 ± 6.62) d respectively. The incidence of hypoglycemia was 8.70% in CSⅡ group and 26.32% in MSⅡ group. The levels of FPG in CS Ⅱ group were (5.12 ± 0.63) mmol / L and 6.26 ± 0.91 mmol / L in CS Ⅱ group, 7.4 ± 0.83 mmol / L in CS Ⅱ group and 9.22 ± 1.03 mmol / L in MS Ⅱ group, respectively. There was significant difference between the two groups (all P <0.01). Conclusion Compared with MS Ⅱ, CS Ⅱ can shorten the days of operation and days of hospitalization, reduce the dosage of insulin, lower the incidence of hypoglycemia and control the blood sugar more smoothly and rapidly.