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胰岛素持续皮下输注(CSII),即胰岛素泵治疗。作为强化治疗的最佳的选择之一,目前使用胰岛素泵的患者人数持续增加,特别是在儿童和青少年患者中。胰岛素泵可使糖化血红蛋白较快达标,且较少血糖波动,减少了低血糖的发生,解决了黎明现象。对经历严重的低血糖,糖化血红蛋白基线水平较高,或者是多次皮下注射胰岛素血糖波动仍然很大的患者来说,胰岛素泵是最优选择。考虑到血糖控制效果、生活质量提高及根据体力活动与食物摄入等调整胰岛素剂量的灵活性等多个因素,胰岛素泵仍然优于皮下多次注射胰岛素。胰岛素泵应用的制约因素是价格高。目前很多研究量化分析得出胰岛素泵对于那些戴泵前后糖化血红蛋白降幅很大及低血糖次数明显减少的患者来说是性价比最高的。然而,胰岛素泵对生活质量的影响很难去量化。胰岛素泵的厂家不断更新胰岛素泵的高级功能,寄予人工胰腺的希望,目前各种高级功能更加人性化,智能化。总之,作为临床医生和患者而言,胰岛素泵的治疗不是简单的携带了一个外在的仪器,胰岛素泵的治疗需要一个团队,需要加强对病人进行各种知识的教育以及很好的跟踪随访。
Insulin continuous subcutaneous infusion (CSII), the insulin pump treatment. As one of the best options for intensive care, the number of patients currently using insulin pumps continues to increase, especially in children and adolescents. Insulin pump can glycosylated hemoglobin faster compliance, and less blood sugar fluctuations, reducing the incidence of hypoglycemia, to solve the dawn phenomenon. Insulin pumps are the optimal choice for patients who experience severe hypoglycemia, high baseline HbA1c levels, or multiple hypodermic injections of insulin and blood glucose fluctuations. Taking into account the effects of blood sugar control, quality of life, and the flexibility to adjust insulin dosage based on physical activity and food intake, the insulin pump is still superior to subcutaneous multiple injections of insulin. The limiting factor for insulin pump applications is the high price. Quantitative analysis of many current studies have shown that insulin pump for those patients wearing glycated hemoglobin before and after a significant decline in the number of low blood sugar significantly reduced the cost is the highest. However, the impact of insulin pumps on quality of life is difficult to quantify. Insulin pump manufacturers continue to update the advanced features of insulin pump, placed the hope of the artificial pancreas, the current variety of advanced features more humane and intelligent. In conclusion, as a clinician and patient, insulin pump therapy does not simply carry an external instrument. Insulin pump therapy requires a team that needs to be educated about the patient’s knowledge and a good follow-up.