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目的:比较持续皮下胰岛素注射(CSII)和持续静脉胰岛素输注(CVII)在合并糖尿病酮症酸中毒(DKA)患者早期治疗中的有效性和合理性。方法:比较两组血糖达标时间、胰岛素用量、酮体和酸中毒纠正的时间、低血糖发生率及治疗前5d血糖水平波动情况。结果:两组血糖达标的时间类似,但CSII组前5d血糖稳定于靶目标值(11.1±2.0mmol/L)比例更高,且血糖的波动更小,前3d胰岛素的用量更小(P均<0.05);两组在酮体转阴、酸中毒纠正的时间以及低血糖的发生上无显著性差异(P均>0.05)。结论:CSII和CVII都能纠正DKA早期的代谢紊乱,但CSII能使血糖更平稳、波动更小,临床使用须根据病情而定。
Objective: To compare the efficacy and rationality of continuous subcutaneous insulin injection (CSII) and continuous intravenous insulin infusion (CVII) in the early treatment of patients with diabetic ketoacidosis (DKA). Methods: The blood glucose compliance time, insulin dosage, ketone body and acidosis time, the incidence of hypoglycemia and the fluctuation of blood glucose level on the 5th day before treatment were compared. Results: The time to reach the goal of glycemic control in both groups was similar. However, the blood glucose of the CSII group was stable at the target value of 11.1 ± 2.0mmol / L in the first 5 days, and the fluctuation of blood glucose was smaller and the amount of insulin in the first 3d was lower <0.05). There was no significant difference between the two groups in the time when ketone body turned negative, acidosis time and the incidence of hypoglycemia (P> 0.05). Conclusion: Both CSII and CVII can correct the early DKA metabolic disorders, but CSII can make blood sugar more stable and less volatile, and clinical use should be based on the condition.