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目的观察强化胰岛素治疗对急诊ICU患者病情及预后的影响。方法将医院急诊ICU收治的130例血糖>11.1 mmol/L的患者随机分成观察组和对照组,每组65例。观察组采用强化胰岛素治疗方案,对照组采用常规胰岛素治疗方案。观察2组抗生素使用时间、胰岛素使用时间、入住ICU天数、院内感染率、病死率及低血糖发生概率;评价2组出科前APACHEⅡ评分及生活质量评分。结果观察组抗生素使用时间、胰岛素使用时间、入住ICU天数均短于对照组,院内感染率、病死率均明显低于对照组,但观察组低血糖发生率高于对照组,出科前APACHEⅡ评分较对照组低,而ADL评分与生活质量评分均高于对照组,差异有统计学意义(P<0.05或P<0.01)。结论对急诊ICU患者采用强化胰岛素治疗方案可明显改善患者病情,降低院内感染概率,缩短入住ICU时间,但需注意低血糖的发生。
Objective To observe the effects of intensive insulin therapy on the condition and prognosis of emergency ICU patients. Methods 130 cases of ICU admitted to the hospital with blood glucose> 11.1 mmol / L were randomly divided into observation group and control group, with 65 cases in each group. Observation group with intensive insulin treatment program, the control group using conventional insulin treatment. The antibiotic use time, insulin use time, days of ICU stay, nosocomial infection rate, fatality rate and the incidence of hypoglycemia in the two groups were observed. The APACHEⅡscore and quality of life score of the two groups were evaluated. Results The observation group antibiotic use time, insulin use, the number of ICU days were shorter than the control group, nosocomial infection and mortality were significantly lower than the control group, but the incidence of hypoglycemia in the observation group was higher than the control group before APACHE Ⅱ score Lower than the control group, while the ADL score and quality of life scores were higher than the control group, the difference was statistically significant (P <0.05 or P <0.01). Conclusions Intensive insulin therapy can significantly improve the patient’s condition, reduce the probability of nosocomial infection and shorten the time of ICU stay in emergency ICU. However, attention should be paid to the occurrence of hypoglycemia.