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目的比较速效、中效胰岛素联合方案与胰岛素泵治疗妇科疾病合并糖尿病围术期患者的临床疗效。方法选取2014年1月—2015年3月广西中医药大学附属瑞康医院妇科的2型糖尿病围术期患者93例,按随机数字表法分为多次胰岛素皮下注射(MSII)组46例与持续皮下胰岛素输注(CSII)组47例。MDII组患者予以诺和锐三餐前皮下注射+诺和灵N 22:00皮下注射,CSII组患者予以胰岛素泵输注诺和锐。观察两组患者三餐前、三餐后2h血糖、血糖达标时间、住院时间、胰岛素用量、降糖费用、住院费用、切口愈合障碍及低血糖发生情况。结果治疗前后两组患者三餐前、三餐后2h血糖比较,差异无统计学意义(P>0.05),两组患者治疗后三餐前、三餐后2h血糖低于治疗前,差异有统计学意义(P<0.05);CSII组患者血糖达标时间、住院时间短于MDII组,胰岛素总用量少于MDII组,降糖费用高于MDII组,差异有统计学意义(P<0.05),两组患者住院费用比较,差异无统计学意义(P>0.05);CSII组患者切口愈合障碍、低血糖发生率低于MDII组,差异有统计学意义(P<0.05)。结论 MDII与CSII治疗妇科疾病合并糖尿病围术期患者的临床疗效相当,CSII可缩短患者血糖达标时间和住院时间,减少胰岛素用量,降低切口愈合障碍及低血糖的发生率。
Objective To compare the clinical effects of quick-acting, medium-acting insulin and insulin pump in the treatment of patients with gynecological diseases complicated with diabetes mellitus. Methods Ninety-three patients with type 2 diabetes underwent gynecological operation from January 2014 to March 2015 in Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were randomly divided into multiple subcutaneous injection of insulin (MSII) group (46 cases) and Continuous subcutaneous insulin infusion (CSII) group of 47 cases. Patients in MDII group were given Connaught and Haruhi subcutaneous injection before meals and subcutaneous injection of Novolin N 22:00. Patients in CSII group were given insulin pump infusion and Rui-Rui. Two groups of patients before meals, 2h after meals, blood glucose, blood glucose compliance time, length of stay, insulin dosage, hypoglycemic costs, hospitalization costs, incision healing disorders and hypoglycemia. Results Before and after treatment, there was no significant difference in blood glucose between the two groups before meals and two hours after meals (P> 0.05). Before and after the two meals, the blood glucose of the two groups before treatment was lower than that before treatment (P <0.05). The CSII patients had shorter blood glucose time, hospital stay shorter than MDII group, less total insulin dosage, lower hypoglycemic cost than MDII group, the difference was statistically significant (P <0.05) There was no significant difference in hospitalization costs between the two groups (P> 0.05). Incision healing and hypoglycemia in CSII group were lower than those in MDII group (P <0.05). Conclusions The clinical efficacy of MDII and CSII in treating gynecological diseases with perioperative diabetes mellitus is similar. CSII can shorten the time and length of hospital stay, reduce the dosage of insulin, reduce the incision healing disturbance and the incidence of hypoglycemia.