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目的 探讨使用胰岛素泵持续皮下输注胰岛素治疗儿童 1型糖尿病合并酮症酸中毒的可行性。方法 将在我院住院的 1型糖尿病合并酮症或酮症酸中毒的患儿 12例 ,分为胰岛素泵治疗组和对照组 ,每组 6例。分别使用胰岛素泵皮下输注胰岛素和小剂量胰岛素静脉滴注 ,常规胰岛素的用量为 0 .0 5～ 0 .10IU/ (kg·h) ,观察血糖、β 羟丁酸、尿酮体的变化。 结果 ( 1)两组患儿的血糖在使用胰岛素泵和静脉小剂量胰岛素滴注治疗后均明显下降 ,两组血糖治疗前后的下降值差异无显著意义。 ( 2 )两组患儿的血 β 羟丁酸在治疗后均恢复正常 ,胰岛素泵治疗组患儿恢复正常的时间 [( 2 .0±0 .9)d]短于对照组 [( 6 .3± 1.8)d],两组差异有非常显著意义 (t=5 .45 ,P <0 .0 1)。 ( 3)胰岛素泵治疗组患儿治疗后尿酮体转阴时间为 ( 6± 3)h ,对照组为 ( 12 8± 45 )h ;两组差异有非常显著意义 (t=6 .6 5 ,P <0 .0 1)。结论 胰岛素泵用于治疗 1型糖尿病合并酮症酸中毒可以取得比对照组更加满意的疗效。
Objective To investigate the feasibility of continuous subcutaneous infusion of insulin with insulin pump in children with type 1 diabetes and ketoacidosis. Methods Twelve patients with type 1 diabetes mellitus or ketoacidosis hospitalized in our hospital were divided into insulin pump treatment group and control group with 6 cases in each group. Subcutaneous infusion of insulin and low dose of insulin were intravenously administered by insulin pump respectively. The amount of conventional insulin was 0.05-0.10 IU / (kg · h). The changes of blood glucose, β-hydroxybutyrate and urine ketone body were observed. Results (1) The blood glucose in both groups decreased significantly after treatment with insulin pump and intravenous low-dose insulin infusion. There was no significant difference between the two groups in blood glucose before and after treatment. (2) The blood β-hydroxybutyrate in both groups returned to normal after treatment, and the time to return to normal in the pump group was shorter than that in the control group [(2.0 ± 0.9) d] [(6. 3 ± 1.8) d]. There was a significant difference between the two groups (t = 5.45, P <0.01). (3) The urinary ketone body time after treatment of insulin pump treatment group was (6 ± 3) h, and that of control group was (12 8 ± 45) h. There was significant difference between the two groups (t = 6.66, P <0 .0 1). Conclusion Insulin pump for the treatment of type 1 diabetes with ketoacidosis can achieve more satisfactory results than the control group.