摘要
Abstract
Objective To observe the clinical effect of dynamic blood glucose monitoring combined with intensive insulin therapy in critically ill patients with hyperglycemia in intensive care unit (ICU).Methods A total of 135 cases of critically ill patients with severe hyperglycemia were randomly divided into control group (n =67) and treatment group (n =68).Control group was given fingertip blood glucose monitoring,3 times a day combined with syringe pump continuous intravenous 2-4 U · h-1 insulin.Treatment group was given dynamic blood glucose monitoring (every 6 h on blood glucose changes recorded) combined with insulin intensive treatment (when patients' initial blood glucose ＞ 12.1 mmol · L-1,the patients were intravenous infusion 4 U · h-1 insulin,if the blood glucose did not decline,the appropriate increase in 1.5-2.0 U · h-1 insulin).Two groups were treated continuously for 2 weeks.The fasting blood glucose (FBG),ICU hospitalization time,mean mechanical ventilation time,mortality and hypoglycemia were observed in two groups.Results After 3,5,7 d treatment,the FBG in treatment group were (6.34 ± 1.48),(5.73 ± 1.23),(5.24 ± 0.86) mmol· L-1,had significant difference with those in control group,which were (8.76 ±2.36),(8.46 ±2.19),(7.59 ±2.19) mmol · L-1(P ＜0.05).The ICU hospitalization time,mean mechanical ventilation time in treatment group were (8.63 ±5.72),(6.25 ±4.61) d,had no significant difference with those in control group,which were (9.78 ±6.34) and (6.75 ±4.78) d (P ＞0.05).There were 7 cases (10.29％) of mortality in treatment group and 11 cases (16.41％) in control group,with no significant difference (P ＞ 0.05).There were 6 cases (8.82％) of hypoglycemia in treatment group and 14 cases (20.89％) in control group,with no significant difference (P ＜ 0.05).Conclusion In the intensive care unit,hyperglycemia patients with dynamic blood glucose monitoring combined with insulin intensive treatment can more accurately grasp hyperglycemia critically ill patients' blood glucose changes,and then more scientific development of insulin use,can quickly reduce the patients' blood glucose and reduce the incidence of hypoglycemia,has a very good clinical efficacy.关键词
高血糖/动态血糖监测/胰岛素强化治疗Key words
hyperglycemia/dynamic blood glucose monitoring/intensive insulin therapy分类
医药卫生
