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目的分析和探讨慢性肺心病合并糖尿病治疗的难点。方法选择从2012年12月至2014年12月在本院进行治疗的慢性肺心病合并糖尿病患者90例,以45例为1组,随机分为观察组和对照组,对照组行常规治疗,在此基础上观察加用皮下注射甘精胰岛素及口服格列美脲治疗,观察并对比两组的治疗效果。结果对照组治疗有效率71.11%,观察组为93.33%,比较差异具有统计学意义(P<0.05)。对照组达到目标血糖用时、住院时间、胰岛素用量分别是8.8±2.4 d、18.8±2.0 d、47.7±3.6 U/d,观察组分别是4.4±1.6 d、12.5±2.2 d、27.6±3.9 U/d,比较差异均具有统计学意义(P<0.05)。结论在慢性肺心病合并糖尿病的常规治疗中加用皮下注射甘精胰岛素及口服格列美脲治疗可显著提升疗效,其治疗难点是作为慢性肺心病的并发症,糖尿病会促进其发展,而慢性肺心病的治疗又会降低控制血糖的能力,容易形成恶性循环。
Objective To analyze and discuss the difficulties in the treatment of chronic cor pulmonale complicated with diabetes. Methods 90 patients with chronic cor pulmonale and diabetes mellitus who were treated in our hospital from December 2012 to December 2014 were randomly divided into observation group and control group, On the basis of observation plus subcutaneous insulin glargine and oral glimepiride treatment, observation and comparison of the two groups of treatment. Results The effective rate of the control group was 71.11% and that of the observation group was 93.33%, the difference was statistically significant (P <0.05). When the control group reached the target blood glucose, the hospitalization time and insulin dosage were 8.8 ± 2.4d, 18.8 ± 2.0d and 47.7 ± 3.6 U / d respectively, and the observation group were respectively 4.4 ± 1.6d, 12.5 ± 2.2d and 27.6 ± 3.9 U / d, the difference was statistically significant (P <0.05). Conclusions The routine treatment of chronic cor pulmonale complicated with diabetes mellitus with subcutaneous glargine and oral glimepiride treatment can significantly improve the efficacy of its treatment is as a complication of chronic pulmonary heart disease, diabetes will promote its development, and chronic Pulmonary heart disease treatment will reduce the ability to control blood sugar, easy to form a vicious circle.