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目的通过研究胰岛素泵持续皮下注射速效人胰岛素类似物(诺和锐)对2型糖尿病病人围手术期血糖的控制情况,探讨糖尿病病人围手术期最佳的血糖控制方法及药物。方法选择60例住院手术的2型糖尿病病人,随机血糖均>20mmol/L,按照自愿的原则分为两组,A组采用诺和锐CSII治疗,B组采用多次皮下胰岛素注射治疗(MSII),观察每组病人治疗前后及两组间治疗后各项临床指标变化。结果两组病人治疗后血糖都明显下降(P<0.01),诺和锐CSII组餐后2h血糖明显低于MSII组(P<0.01),术中血糖明显低于MSII组(P<0.01),胰岛素用量也少于MSII组(P<0.01)。诺和锐CSII组达到血糖良好指标的时间及平均术前住院天数也少于后者(P<0.01)。低血糖发生也较少。结论胰岛素泵持续皮下注射诺和锐能迅速、有效、安全、平稳地控制全天血糖,明显优于传统皮下多次注射胰岛素,是2型糖尿病病人围手术期控制血糖强化治疗的首选方案及药物。
Objective To study the perioperative control of blood glucose in patients with type 2 diabetes mellitus by continuous subcutaneous injections of insulin pump (Novo-sharp) with insulin pump and to explore the best glycemic control methods and drugs in perioperative period. Methods Sixty hospitalized patients with type 2 diabetes mellitus were randomly divided into two groups according to the principle of voluntarism. The patients in group A were treated with Novo-sharp CSII, and the group B with multiple subcutaneous insulin injections (MSII) , Observed each group of patients before and after treatment and between the two groups after treatment of various clinical indicators. Results The blood glucose of the two groups were significantly decreased after treatment (P <0.01). The blood glucose of Novo Nordil-C sharp group was significantly lower than that of MSII group 2h after meal (P <0.01) Insulin was also less than the MSII group (P <0.01). Novo and sharp CSII group to achieve good indicators of blood glucose time and the average preoperative hospital stay is also less than the latter (P <0.01). Hypoglycemia also occurs less. CONCLUSION: Continuous and subcutaneous injection of Novolin can quickly and effectively, safely and smoothly control all-day blood glucose, which is obviously superior to traditional subcutaneous multiple injections of insulin. It is the first choice for perioperative management of glycemic excretion in patients with type 2 diabetes mellitus .