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目的比较不同胰岛素给药方法治疗糖尿病合并脑卒中的疗效。方法将76例糖尿病患者分为胰岛素泵持续皮下注射(CSII)组及胰岛素多次皮下注射(MSII,4次/d)组。静脉输注5%葡萄糖溶液者,CSII组每4g葡萄糖同步增加基础量胰岛素1U;MSII组用微量注射器同步静脉注射胰岛素1U。结果治疗期间血糖平均值、血糖达标时间、低血糖(血糖<2.78mmol/L)发生率两组间比较,差异均有统计学意义[(7.86±1.15)vs(10.05±1.87)mmol/L;(3.53±1.16)vs(6.49±2.75)d;23.7%vs 57.9%,P<0.01];治疗后14d,两组间神经功能缺损程度(NIHSS)比较,差异有统计学意义[(21.63±4.73)vs(24.06±5.15)分,P<0.05];两组间并发症发生率、死亡率比较,差异无统计学意义(23.7%vs 39.5%,5.3%vs 10.5%,P>0.05)。发病后3个月,两组Barthel指数评分比较,差异有统计学意义(P<0.05)。结论 CSII治疗糖尿病合并脑卒中,在血糖控制和神经功能恢复方面疗效优于MSII。
Objective To compare the curative effects of different insulin administration methods on diabetic patients complicated with stroke. Methods 76 cases of diabetic patients were divided into insulin pump continuous subcutaneous injection (CSII) group and insulin multiple subcutaneous injection (MSII, 4 times / d) group. Intravenous infusion of 5% glucose solution, CSII group of glucose per 4g increase the basic amount of insulin 1U; MSII group with a small syringe intravenous injection of insulin 1U. Results The average blood glucose level, blood glucose compliance time and the incidence of hypoglycemia (blood glucose <2.78mmol / L) during the treatment period were significantly different between the two groups [(7.86 ± 1.15) vs (10.05 ± 1.87) mmol / L; (3.53 ± 1.16) vs (6.49 ± 2.75) d, 23.7% vs 57.9% (P <0.01). There was a significant difference in the NIHSS between the two groups 14 and 14 days after treatment (21.63 ± 4.73 ) vs (24.06 ± 5.15) points, P <0.05]. There were no significant differences in complication rates and mortality between the two groups (23.7% vs 39.5%, 5.3% vs 10.5%, P> 0.05). At 3 months after onset, there was significant difference between the two groups in Barthel index score (P <0.05). Conclusion CSII is superior to MSII in the treatment of diabetes mellitus and stroke in terms of blood sugar control and neurological function recovery.