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目的探讨重症患者采用胰岛素强化治疗方案控制血糖相比于传统疗法的安全性及效果观察。方法选取2011年11月~2014年2月我院ICU病人68例,随机分为强化治疗组和传统治疗组(n=34)。强化治疗组采用胰岛素持续泵入控制血糖,传统组采用传统治疗方案(早、中、晚定时静脉推注胰岛素)。观察患者血糖控制水平、死亡率、新器官衰竭发生率及严重低血糖发生率以评估其安全性及效果。结果胰岛素强化治疗组血糖控制平均值为(7.3±1.8)mmol/L,明显好于传统组血糖控制水平(12.8±1.4),p<0.05,差异有统计学意义;胰岛素强化治疗组患者死亡率(5.9%)、新器官衰竭发生率(23.5%)及严重低血糖发生率(2.9%)均优于传统组患者,P<0.05,差异有统计学意义。结论采用胰岛素强化治疗方案能够较好控制患者血糖水平,降低患者死亡率、减少新器官衰竭并能减少严重低血糖发生,值得临床推广。
Objective To investigate the safety and efficacy of intensive insulin therapy for controlling blood glucose in critically ill patients compared with traditional therapy. Methods Sixty-eight patients with ICU in our hospital from November 2011 to February 2014 were randomly divided into intensive treatment group and traditional treatment group (n = 34). Intensive treatment group using continuous insulin pump control of blood glucose, the traditional group using the traditional treatment (early, middle and late regular intravenous insulin). Observe the level of blood glucose control, mortality, the incidence of new organ failure and severe hypoglycemia incidence rate to assess its safety and effectiveness. Results The average value of blood glucose control in intensive insulin therapy group was (7.3 ± 1.8) mmol / L, which was significantly better than that in the control group (12.8 ± 1.4), p <0.05, the difference was statistically significant. The mortality rate in intensive insulin therapy group (5.9%), the incidence of new organ failure (23.5%) and the incidence of severe hypoglycemia (2.9%) were better than the traditional group, P <0.05, the difference was statistically significant. Conclusion Intensive insulin therapy can better control the blood glucose level, reduce the mortality of patients, reduce the failure of new organs and reduce the incidence of severe hypoglycemia, which is worthy of clinical promotion.