目的 探究老年糖尿病患者髋部骨折围手术期使用胰岛素泵治疗的疗效.方法 回顾性选取2013年1月 ～2018年1月在包钢医院及北京积水潭医院接受治疗的老年髋部骨折手术合并糖尿病患者92例,采用随机数表法分为对照组和观察组各46例,对照组围手术期给予皮下注射胰岛素治疗;观察组围手术期给予胰岛素泵持续皮下注射治疗,对两组患者手术前后血糖指标、血糖达标时间、胰岛素用量以及预后进行综合评价.结果 观察组患者术中及术后血糖指标均较对照组低,差异有统计学意义(P＜0.05);观察组患者血糖达标时间、胰岛素用量均少于对照组,差异有统计学意义(P＜0.05);且观察组患者术后低血糖、切口愈合障碍分别为4.35%、2.17%,显著低于对照组,差异有统计学意义(P＜0.05).结论 老年糖尿病患者髋部骨折围手术期使用胰岛素泵治疗,能够促进患者血糖指标改善,降低胰岛素用量,并发症少,值得推广应用.%Objective This study explored the curative effect of insulin pump in the perioperative period of hip fracture in elderly patients with diabetes mellitus. Methods The study selected 92 senile hip fracture surgery patients with diabetes mellitus who were treated in Baogang hospital and Jishuitan hospital from January 2013 to January 2018. With random number table method, they were divided into observation group and control group, each includes 46 cases. In the control goup, perioperative was given subcutaneous injections of insulin treatment;In the observation group, perioperative was given continuous subcutaneous injection of insulin pump treatment. The study did a comprehensive evaluation on blood sugar,the marked time before or after patients operation, dosage of insulin. Results The blood glucose indexes of observation group was lower than that of control group (P ＜ 0.05), which was statistically significant. For the observation group, blood glucose standard time and insulin dosage was lower than that of the control group. (P ＜ 0.05),which was statistical significance. In the observation group, the postoperative hypoglycemia and wound healing disorders revealed 4.35% and 2.17% respectively, which was significantly lower than that of the control group (χ2=7.497,t2=9.592,P ＜ 0.05),with statistically significant. Conclusion The use of insulin pump for the perioperative period of hip fracture in elderly diabetic patients can promote the improvement of blood glucose index, lower insulin dosage and may lessen complications, so it is worth promoting the application.
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