摘要
目的比较基于动脉血糖控制方案与强化胰岛素治疗在ICU患者中的应用效果。方法将545例危重症术后患者分为对照组280例和实验组265例。对照组采用强化胰岛素治疗控制血糖;实验组采用动脉血糖为指导的血糖控制新方案。结果实验组术后入ICU 48h内血糖监测次数、胰岛素用量、血糖值、血糖<4 mmol/L发生率与对照组比较,差异有统计学意义(P<0.05,P<0.01);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论以动脉血糖为指导的血糖控制新方案较强化胰岛素治疗方案,能减少血糖监测次数和低血糖发生次数,降低胰岛素用量,在未增加并发症发生率的同时,能够将血糖控制在比较安全的范围,使患者最大获益,同时也减轻护理工作量。
Objective To compare the different clinical result between a new method of glycemic control based on arterial blood glucose and an intensive insulin therapy（IIT）in intensive care unit（ICU）.Methods A total of 545 critically ill patients were randomly divided into an experimental group（n=265）and a control group（n=280）.The former received a new glycemic control therapy based on the arterial blood glucose,while the latter was on IIT.Results Significant differences were found in the frequency of glucose monitoring,the dosage of insulin,the levels of glycemia within the first 48 hin ICU and the counts of hypoglycemia between the two groups（P〈0.05,P〈0.01）.However,there was no significant difference in the occurrence of complications between them（P〉0.05）.Conclusion The glycemic control therapy based on the arterial blood glucose is superior to traditional IIT in lowering the frequency of glucose monitoring,the dosage of insulin and occurrence of hypoglycemia without increasing complications,which can benefit patients from safe glycemic control and cut nurses′work load.
关键词
危重症患者
手术后
ICU
血糖控制
强化胰岛素治疗
动脉血糖
critically ill patients
post-operation
intensive care uint
glycemic control
intensive insulin therapy
arterialglucose
