论文部分内容阅读
目的探讨胰岛素激发试验中临床护理的重点和胰岛素激发试验在儿童矮小症诊断中应用的安全性。方法选择2004年7～9月进行胰岛素激发试验的121例矮小症患儿,胰岛素激发试验操作前禁食10h,试验时静脉推注普通胰岛素0.1U/kg,于注射后0、15、30、60和90min各采2ml全血检测生长激素,同时监测上述时间点的血糖、心率和血压等。结果血糖低谷主要发生在应用胰岛素后15～30min,最低血糖值与患儿体重呈正相关(P<0.05)。试验中未见有明显低血压,各时段心率和舒张压有差异(P均<0.05)。有低血糖临床表现13例(10.74%),其中2例在追加胰岛素以后出现低血糖表现,经积极处理,均未发生严重后果。结论在胰岛素激发试验中要密切监测血糖、心率和血压等指标,在15～30min时段注意低血糖发作,特别是体重较轻的儿童。只要护理工作做到认真细致、及时处理,该试验在儿童矮小症诊断中是安全的。
Objective To investigate the focus of clinical nursing in insulin provocation test and the safety of insulin provocation test in the diagnosis of children with short stature. Methods A total of 121 short stature cases undergoing insulin challenge test from July to September in 2004 were selected and fasted for 10 hours before insulin stimulation test. Normal insulin 0.1U / kg was injected intravenously at 0, 15, 30, 60 and 90min mining 2ml of whole blood test for growth hormone, while monitoring the time point of blood glucose, heart rate and blood pressure. Results Low blood glucose mainly occurred 15 to 30 minutes after the application of insulin. The lowest blood sugar level was positively correlated with the weight of children (P <0.05). There was no significant hypotension in the trial, and heart rate and diastolic blood pressure were significantly different at different time points (all P <0.05). There were 13 cases (10.74%) with hypoglycemia clinical manifestations, of which 2 cases showed hypoglycemia after adding insulin, and no serious consequences were found after active treatment. Conclusion Insulin test should be closely monitored blood glucose, heart rate and blood pressure and other indicators, in the 15 ~ 30min period of attention to hypoglycemic attacks, especially in light weight children. As long as the nursing work is done meticulously and promptly, the test is safe for the diagnosis of STD.