目的:比较持续皮下胰岛素输注(CSII)与常规皮下注射胰岛素治疗2型糖尿病、酮症酸中毒临床效果.方法:将住院的80例2型糖尿病患者分为治疗组和对照组,每组各40例.治疗组采用胰岛素泵治疗,对照组采用皮下注射胰岛素.比较两种治疗方法在血糖控制时间、胰岛素用量、低血糖发生率及尿酮体转阴天数方面的差异.结果:治疗组与对照组的尿酮体转阴天数分别为(2.90±1.41)、(4.35±1.24)d,胰岛素用量分别为(39.84±11.24)、(53.21±10.45)U/d,达靶血糖时间分别为(6.03±2.13)、(9.32±4.15)d,低血糖发生率分别为5.0%、20.0%,治疗3个月时HbA1c水平分别为(7.02±1.84)%、(7.84±1.92)%,两组比较,差异均有统计学意义(P<0.05或P<0.01).两组患者治疗后4个时间段血糖值比较,治疗组低于对照组,差异有统计学意义(P<0.05或P<0.01).结论:采用CSII与常规皮下注射胰岛素相比较,达靶血糖时间明显缩短,尿酮体转阴时间缩短,并且降低了低血糖的发生率,具有安全、有效、稳定的特点.%Objective: To compare the clinical effects of continuous subcutaneous Insulin infusion (CSII) and conventional subcutaneous Insulin injection in treatment of type 2 diabetes and diabetic ketoacidosis. Methods: 80 hospitalized patients with type 2 diabetes were divided into treatment group (40 cases) and control group (40 cases) which received insulin pump and subcutaneous injection of Insulin respectively. Blood glucose control time, Insulin dosage, incidence rate of hypoglycemia and days of negative conversion of urine ketone of the two groups were compared. Results: In the treatment and the control group, the days of negative conversion of urine ketone were (2.90±1.41), (4.35±1.24) d respectively, Insulin dosages were (39.84±11.24), (53.21 ±10.45) U/d respectively, the target blood glucose reaching time were (6.03±2.13), (9.32±4.15) d respectively, the hypoglycemia incidence rates were 5.0％ and 20.0％ respectively, and the HbA1c levels after treatment for 3 months were (7.02±1.84)％ and (7.84±1.92)％ respectively, and there were significant differences between them (P＜0.05 or P＜0.01). Blood glucose levels in four different periods after treatment of the two groups were compared, the treatment group was obviously lower than that of the control group, and there were significant differences between them (P＜0.05 or P＜0.01). Conclusion: Compared with conventional subcutaneous insulin injection, CSII has obviously reduced the time to reach target blood glucose, the negative reversion time of urine ketone and the incidence rate of hyperglycemia, which is safe, effective and stable.
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