2型糖尿病患者术后胰岛素治疗方案的比较研究
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Comparative study on the insulin treatment plans for patients with type 2 diabetes mellitus after operation
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    摘要:

    目的:比较2型糖尿病患者术后3种胰岛素治疗方案的有效性、安全性和患者耐受性。方法: 选择接受外科手术且术后禁食或进食不规律的2型糖尿病患者,分设胰岛素泵(CSⅡ)组、长效胰岛素(来得时)组和持续静脉输注胰岛素(CVⅡ)组,观察用药前后空腹血糖(FBG)和餐后血糖(PBG)的变化、血糖控制水平及低血糖发生率。结果: CSⅡ组和来得时组治疗后3、5、7及10天的FBG和PBG水平均较治疗前显著降低(P < 0.01),CVⅡ组治疗后3、5、7及10天的FBG水平较治疗前显著降低(P < 0.01),但仅治疗后第7天的PBG水平较治疗前显著降低(P < 0.05),其他时间点PBG水平均较治疗前无差别;治疗10天时,CSⅡ组FBG控制尚可,PBG控制良好,来得时组FBG和PBG控制均尚可,CVⅡ组均差;患者依从性:CSⅡ组较好,来得时组好,CVⅡ组较差;CSⅡ组无低血糖发生,来得时组和CVⅡ组分别发生1次和4次低血糖事件。结论:2型糖尿病患者术后禁食或进食不规律阶段,采用胰岛素泵和来得时均能有效控制血糖,且不易出现低血糖;使用静脉输注胰岛素治疗,血糖波动较大且患者依从性差;来得时是一种有效、安全且患者易接受的用于2型糖尿病患者术后治疗的药物。

    Abstract:

    Objective:To compare the effectiveness, security and survivability of three insulin treatment plans for patients with type 2 diabetes mellitus(T2DM) after operation. Methods:The patients with T2DM receiving surgical intervention and having no or irregular food after operation were enrolled in this study. They were divided into three groups:continuous subcutaneous insulin infusion(CSⅡ) group, long-acting insulin(Lantus) group and continuous intravenous insulin infusion(CVⅡ) group. The fast blood glucose(FBG), postprandial blood glucose(PBG), the control level of blood glucose and hypoglycemia occurrence after treatment were detected. Results:The level of FBG and PBG on the 3rd, 5th, 7th and 10th day after treatment were obviously decreased in both CSⅡ group and Lantus group(P < 0.01). The level of FBG on the 3rd, 5th, 7th and 10th day after treatment were obviously decreased in CVⅡ group(P < 0.01), but the level of PBG was only decreased on the 7 th day(P < 0.05); On the 10 th day, the level of FBG in CSⅡ group was controlled acceptably, and the level PBG was controlled well. The level of FBG and PBG in Lantus group were all controlled acceptably, but they were controlled terribly in CVⅡ group; The compliance of patients was common in CSⅡ group, good in Lantus group and bad in CVⅡ group. There was no hypoglycemia case in CSⅡ group and there were 1 and 4 cases of hypoglycemia in Lantus group and CVⅡ group respectively. Conclusion:For the patients with T2DM receiving surgical intervention and having no or irregular food after operation, insulin pump and Lantus both can control the blood glucose level effectively and have low rate of hypoglycemia. The treatment of CVII has bad control of the blood glucose level and bad compliance. Lantus is a effective, safe and digestible drug for the patient with T2DM after operation.

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吴 静,华一兵,马建华,吴锦丹,马向华.2型糖尿病患者术后胰岛素治疗方案的比较研究[J].南京医科大学学报(自然科学版),2007,(3):256-259

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  • 收稿日期:2006-09-05
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