摘要
目的探讨目标血糖控制在老年重症肺炎集束化治疗中的临床意义。方法选取60例既往无糖尿病病史的老年重症肺炎患者为研究对象，收住呼吸重症医学科（RICU）时患者平均血糖为（12．6±5．9）mmol／L。将患者随机分为对照组和观察组，每组30例。两组患者均给予氧疗、抗感染、化痰、纠正酸碱失衡及水电解质紊乱、营养支持等治疗。在此基础上。对照组患者采用强化血糖控制治疗，使血糖水平控制在4．0～6．1mmol／L，观察组患者实施目标血糖控制治疗，使血糖水平控制在6．1～10．0mmol／L。比较两组患者治疗后低血糖发生率、住RICU天数、病死率。结果观察组患者治疗后低血糖发生率、病死率低于对照组患者，但差异无统计学意义（P〉0．05）；观察组患者住RICU天数显著短于对照组患者，差异有统计学意义（P〈0．01）。结论目标血糖控制在老年重症肺炎的集柬化治疗中，能在一定程度上降低患者的低血糖发生率及病死率，显著缩短患者住RICU时间。
Objective To investigate the clinical significance of target glycemic control in care bundle treatment of elderly patients with severe pneumonia. Methods 60 patients with severe pneumonia were enrolled. Subjects eligible for this study were elderly patients of severe pneumonia with no prior history of diabetes and had glucose concentrations of （ 12.6 ± 5.9） mmol/L on admission. Subjects were randomly assigned to control group （n = 30） and observation group （n = 30）. Both groups were received conventional treatment, including oxygen therapy, anti-infection, dissolve sputum, correct acid-base balance, keep water and electrolyte balance and nutritional support. The control group was adopted intensive glucose control, glucose was controlled at （4.0 -6.1 ） mmol/L, while observation group was received target glycemic control, glucose was controlled at （6.1 -10. 0） mmol/L. The hypoglycemia, length of RICU stay and mortality of two groups were compared after treatment. Results The incidence of hypoglycemia and mortality in observation group were lower than that of control group, but there was no significant difference between two groups （P 〉 0.05 ） ; the control group had longer length of RICU stay compared to observation group, the difference was statistically significant （ P 〈 0.05 ）. Conclusions The target glycemic control in care bundle treatment of severe pneumonia in the elderly can reduce the incidence of hypoglycemia, shorten length of RICU stay and reduce mortality.
出处
《内科》
2015年第3期297-298,314,共3页
Internal Medicine
关键词
目标血糖控制
老年重症肺炎
治疗
Target glycemic control
Elderly
Severe pneumonia
Treatment
