小剂量胰岛素泵持续皮下注射在急诊糖尿病酮症酸中毒治疗中的应用

邓柱安

[摘要] 目的 探析小剂量胰岛素泵持续皮下注射在急诊糖尿病酮症酸中毒治疗中的应用效果。方法 选取该院于2018年1月—2019年5月收治的40例急诊糖尿病酮症酸中毒患者为主要对象，用数字随机表法将其分为对照组与观察组，各20例。两组患者均接受常规对症治疗，观察组在对症治疗的基础上增加小剂量胰岛素泵持续皮下注射，对两组的治疗效果进行对比。结果 两组患者治疗后的空腹血糖水平对比，差异无统计学意义（P>0.05）;观察组患者的血糖达标时间、血酮转阴时间、尿酮转阴时间均短于对照组，差异有统计学意义（P<0.05）;观察组患者的胰岛素用量少于对照组，组间比较差异显著（P<0.05）;观察组患者的低血糖发生率显著低于对照组，两组对比差异有统计学意义（P<0.05）。结论 在急诊糖尿病酮症酸中毒治疗中应用小剂量胰岛素泵持续皮下注射更有利于患者各项指标的改善，减少胰岛素的使用量，避免发生低血糖，总体治疗优势显著。

[关键词] 小剂量胰岛素泵持续皮下注射;急诊;糖尿病酮症酸中毒;治疗效果

[中圖分类号] R587.2          [文献标识码] A          [文章编号] 1672-4062（2020）06（a）-0180-03

[Abstract] Objective To explore the effect of continuous subcutaneous injection of low-dose insulin pump in the treatment of emergency diabetic ketoacidosis. Methods Forty cases of emergency diabetic ketoacidosis patients admitted in the hospital from January 2018 to May 2019 were selected as the main subjects， and they were divided into a control group and an observation group with a random number table method， 20 cases each. Both groups of patients received conventional symptomatic treatment. The observation group added a small-dose insulin pump and continued subcutaneous injection on the basis of symptomatic treatment to compare the treatment effects of the two groups. Results There was no statistically significant difference in fasting blood glucose levels between the two groups of patients after treatment（P>0.05）; the observation group patients blood glucose reaching time， blood ketone turning negative time， and urine ketone turning negative time were shorter than the control group， the difference was statistically significant（P<0.05）; the amount of insulin in the observation group is less than the control group， the difference between the groups is statistically significant（P<0.05）; the incidence of hypoglycemia in the observation group is significantly lower than the control group， the difference between the two groups is statistically significant（P<0.05）. Conclusion In the emergency treatment of diabetic ketoacidosis， the continuous subcutaneous Injection of low-dose insulin pump is more conducive to the improvement of patients' indicators， reducing the amount of insulin used， avoiding the occurrence of hypoglycemia， the overall treatment advantage is significant.

[Key words] Continuous subcutaneous injection of low-dose insulin pump; Emergency; Diabetic ketoacidosis; Treatment effect

糖尿病是临床上发病率非常高的慢性代谢性疾病，糖尿病患者长期处于高血糖水平，会引发系列并发症，进而导致患者出现残疾甚至是病死。糖尿病酮症酸中毒是糖尿病患者的常见急性并发症，患者病情进展快，需要予以积极的预防和治疗，否则将会危及患者的生命健康。目前临床上主要以外源性胰岛素补充为主要治疗方法，根据胰岛素的分泌规律向人体内注射胰岛素以维持血糖稳定，实现快速、平稳降糖，进而改善机体氧化应激反应[1-2]。但是不同的给药方法获得的治疗效果存在一定差异，现选取该院在2018年1月—2019年5月收治的40例急诊糖尿病酮症酸中毒患者作为研究对象，进一步分析和评价小剂量胰岛素泵持续皮下注射的治疗效果，现报道如下。