胰岛素泵治疗急诊糖尿病酮症酸中毒的疗效分析

DOI：10.16658/ki.1672-4062.2024.04.175胰岛素不同给药方式在ICU糖尿病酮症酸中毒患者治疗中应用的效果分析蔡婷茹，吴珊蓉，胡晓红晋江市医院，福建泉州362200[摘要]目的分析胰岛素不同给药方式在ICU糖尿病酮症酸中毒患者治疗中应用的效果。

方法选取2021年6月—2023年5月在晋江市医院ICU治疗的72例糖尿病酮症酸中毒患者，用随机数表法将其分为两组，各36例。

对照组多次静脉滴注小剂量胰岛素治疗，观察组微量输液泵持续泵入胰岛素治疗，对比两组指标、疗效、不良反应发生率。

结果观察组症状恢复速度快于对照组，胰岛素用量低于对照组，差异有统计学意义（P均<0.05）。

治疗前两组血糖水平对比，差异无统计学意义（P>0.05），观察组治疗后血糖水平低于对照组，差异有统计学意义（P<0.05）。

观察组临床疗效高于对照组，不良反应发生率低于对照组，差异有统计学意义（P均<0.05）。

结论微量（11 mg）输液泵持续泵入在ICU治疗的糖尿病酮症酸中毒患者治疗中应用的效果较为显著，有效改善患者临床症状，降低血糖水平，减少不良反应的发生率。

[关键词] 胰岛素；不同给药方式重症监护；糖尿病；酮症酸中毒；治疗效果[中图分类号] R587.2 [文献标识码] A [文章编号] 1672-4062（2024）02（b）-0175-04Effect of Different Administration Modes of Insulin in ICU Patients with Diabetic KetoacidosisCAI Tingru, WU Shanrong, HU XiaohongJinjiang Hospital, Quanzhou, Fujian Province, 362200 China[Abstract] Objective To analyze the effect of different administration modes of insulin in ICU patients with diabetic ketoacidosis. Methods A total of seventy-two patients with diabetic ketoacidosis treated in the ICU of Jinjiang Hospi⁃tal from June 2021 to May 2023 were divided into two groups with thirty-six cases each by random table method. The control group was treated with low doses of insulin intravenously for several times, and the observation group was treated with insulin continuously by micro infusion pump.The inter-group indexes, efficacy and incidence of adverse reactions were compared. Results The recovery rate of symptoms in observation group was faster than that in control group, and the dosage of insulin was lower than that in control group, the differences were statistically significant (both P<0.05). There was no significant difference in blood glucose level between the two groups before treatment (P>0.05), and the blood glucose level in the observation group was lower than that in the control group after treatment, the differ⁃ence was statistically significant (P<0.05). The clinical efficacy of observation group was higher than that of control group, and the incidence of adverse reactions was lower than that of control group, the differences were statistically sig⁃nificant (P<0.05). Conclusion The application of micro infusion pump (11 mg) continuously in the treatment of dia⁃betic ketoacidosis patients treated in ICU has a significant effect, effectively improving clinical symptoms of patients, reducing blood glucose levels, and reducing the incidence of adverse reactions, which is worthy of promotion and ap⁃plication in clinical treatment.[Key words] Insulin; Different modes of administration; ICU; Diabetes mellitus; Ketoacidosis; Therapeutic effect[作者简介]蔡婷茹（1989-），女，本科，研究方向为ICU。

胰岛素泵治疗糖尿病酮症酸中毒的疗效摘要：目的研究分析胰岛素泵治疗糖尿病酮症酸中毒的疗效。

方法选择医院中2021年8月至2022年5月期间的糖尿病酮症酸中毒患者80例，按照随机数字法分组为观察组以及对照组每组40例。

对照组患者接受小剂量胰岛素的静脉输注治疗。

观察组患者接受胰岛素泵的连续皮下注射治疗。

对比两组血酮体以及尿酮体转阴时间。

结果观察组患者的血酮体转阴时间以及尿酮体转阴时间均显著短于对照组（P<0.05）。

结论胰岛素泵治疗在处理DKA患者方面表现出令人满意的临床效果。

它能够有效地维持患者的血糖水平在可接受范围内，缩短了尿液中酮体的存在时间，并且降低了患者面临的并发症风险。

此外，胰岛素泵治疗方法的简便性、安全性和高效性也得到了肯定。

关键词：胰岛素泵；糖尿病；酮症酸中毒糖尿病是一种慢性代谢性疾病，全球范围内影响着数百万人的健康。

随着现代生活方式的变化和不健康饮食习惯的普及，糖尿病的患病率在不断上升。

其中，2型糖尿病和1型糖尿病是最常见的两种类型，它们都伴随着高血糖（高血糖）的特征。

然而，糖尿病患者面临的挑战不仅仅是高血糖[1]。

糖尿病患者还可能遭受一种危险的并发症，即糖尿病酮症酸中毒（DKA）。

DKA是一种严重的代谢紊乱，通常表现为高血糖、酮体积累和代谢性酸中毒。

它是一种危及生命的糖尿病急性并发症，如果不及时干预，可能导致昏迷和死亡。

传统上，DKA的治疗依赖于静脉注射胰岛素和液体复苏。

然而，近年来，胰岛素泵（也称为胰岛素泵疗法或胰岛素泵治疗）作为一种更有效、更精确、更人性化的治疗方式，已经在DKA的管理中引起了广泛关注和研究。

胰岛素泵允许患者通过持续的胰岛素输注来更好地控制血糖水平，从而减少DKA的风险。

1资料和方法1.1一般资料选择医院中2021年8月至2022年5月期间的糖尿病酮症酸中毒患者80例，按照随机数字法分组为观察组以及对照组每组40例。

观察组患者男性27例，女性13例，年龄49岁至71岁，平均年龄（59.82±2.63）岁。

DOI：10.16658/ki.1672-4062.2023.24.167微量泵持续泵入胰岛素治疗重症糖尿病酮症酸中毒患者的疗效及对血糖水平、胰岛素用量的影响李伟，蒋兴，吴建光福建省邵武市立医院重症医学科，福建邵武354000[摘要]目的研究微量泵持续泵入胰岛素治疗重症糖尿病酮症酸中毒患者的实际应用效果。

方法选取2021年1月—2023年4月期间于福建省邵武市立医院进行治疗的84例重症糖尿病酮症酸中毒患者作为研究对象，根据住院编号的奇偶数分为对照组42例（奇数）和观察组42例（偶数）。

对照组接受静脉滴注胰岛素治疗，观察组接受微量泵持续泵入胰岛素治疗。

比较两组临床疗效、血糖水平、胰岛素用量及发生低血糖次数。

结果治疗后，观察组临床疗效优于对照组，差异有统计学意义（P均<0.05）。

观察组血糖水平均低于对照组，差异有统计学意义（P均<0.05）。

观察组胰岛素用量、低血糖发生次数均少于对照组，差异有统计学意义（P均<0.05）。

结论胰岛素微量泵持续泵入方式在治疗重症糖尿病酮症酸中毒患者方面，展现出较快地控制血糖水平、迅速稳定血液中血酮和尿酮体浓度、减少胰岛素用量及低血糖的发生次数等优点，临床疗效较高。

[关键词] 微量泵；胰岛素；血糖水平；重症糖尿病酮症酸中毒[中图分类号] R587 [文献标识码] A [文章编号] 1672-4062（2023）12（b）-0167-04Effect of Continuous Pumping of Insulin by Micropump in the Treatment of Patients with Severe Diabetic Ketoacidosis and the Influence of Insulin Dosage on Blood Glucose LevelLI Wei, JIANG Xing, WU JianguangDepartment of Critical Care Medicine, Shaowu Municipal Hospital, Shaowu, Fujian Province, 354000 China[Abstract] Objective To study the effect of micropump continuous pumping insulin in the treatment of patients with severe diabetic ketoacidosis. Methods A total of 84 patients with severe diabetic ketoacidosis who were treated in Sha‑owu Municipal Hospital of Fujian Province from January 2021 to April 2023 were selected as the study objects, and were divided into control group (42 cases) (odd number) and observation group (42 cases) (even number) according to the odd and even number of hospitalization numbers. The control group received intravenous insulin therapy, and the observation group received continuous insulin therapy with micropump. The clinical efficacy, blood glucose level, insu‑lin dosage and frequency of hypoglycemia were compared between the two groups. Results After treatment, the clini‑cal efficacy of the observation group was better than that of the control group, and the difference was statistically sig‑nificant (all P<0.05). The blood glucose level of observation group was lower than that of control group, and the differ‑ence was statistically significant (all P<0.05). The dosage of insulin and the frequency of hypoglycemia in the observa‑tion group were lower than those in the control group, and the differences were statistically significant (both P<0.05).Conclusion In the treatment of patients with severe diabetic ketoacidosis, insulin micropump continuous pumping has shown the advantages of rapidly controlling blood glucose level, rapidly stabilizing the concentration of blood ketone [作者简介]李伟（1983-），男，本科，主治医师，研究方向为重症医学。

DOI：10.16658/ki.1672-4062.2023.13.185胰岛素在急诊治疗糖尿病酮症酸中毒患者治疗中的作用徐慧1，吴红艳2，蔡倩21.盱眙县人民医院重症医学科，江苏盱眙211700；2.盱眙县人民医院内分泌科，江苏盱眙211700[摘要]目的探讨胰岛素在急诊治疗糖尿病酮症酸中毒患者治疗中的临床疗效及其安全性。

方法选取2019年1月—2022年12月在盱眙县人民医院进行相关治疗的60例糖尿病酮症酸中毒患者为研究对象。

按照信封法进行随机等分处理，对照组予以常规急诊治疗，观察组予以胰岛素治疗。

监测两组患者空腹血糖、餐后2 h血糖及糖化血红蛋白指标，同时记录血糖达标时间、尿酮转阴时间、并发症（昏迷、低血钾、低血糖）发生情况，对比分析临床治疗效果。

结果观察组治疗总有效率高于对照组，差异有统计学意义（P<0.05）；观察组空腹血糖、餐后2 h血糖以及糖化血红蛋白指标水平均较对照组更优，差异有统计学意义（P<0.05）；观察组血糖达标时间和尿酮转阴时间均更短于对照组，差异有统计学意义（P<0.05）；观察组并发症发生率与对照组相比明显更低，差异有统计学意义（P<0.05）。

结论急诊治疗糖尿病酮症酸中毒患者期间，加入胰岛素治疗会明显提高治疗效果，改善机体血糖状态，缩短血糖达标与尿酮转阴时间，减少并发症发生风险，保证患者治疗成效。

[关键词] 胰岛素；急诊治疗；糖尿病酮症酸中毒；血糖指标；有效性；并发症[中图分类号] R4 [文献标识码] A [文章编号] 1672-4062（2023）07（a）-0185-04The Role of Insulin in the Emergency Treatment of Patients with Diabetic KetoacidosisXU Hui1, WU Hongyan2, CAI Qian21.Department of Critical Care Medicine, Xuyi County People's Hospital, Xuyi, Jiangsu Province, 211700 China;2.De⁃partment of Endocrinology, Xuyi County People's Hospital, Xuyi, Jiangsu Province, 211700 China[Abstract] Objective To investigate the clinical efficacy and safety of insulin in the emergency treatment of patients with diabetic ketoacidosis. Methods A total of 60 patients with diabetic ketoacidosis who received relevant treatment in Xuyi County People's Hospital from January 2019 to December 2022 were selected as the subjects of the study. The patients in the control group were given routine emergency treatment, and the observation group was given insulin therapy. The fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin indexes were moni⁃tored, at the same time, the time of blood glucose reaching the standard, the time of urine ketone turning negative, and the occurrence of complications (coma, hypokalemia, hypoglycemia) were recorded, and the clinical treatment effect was compared and analyzed in the two groups. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05); the levels of fasting blood glu⁃cose, 2-hour postprandial blood glucose and glycosylated hemoglobin in the observation group were better than those in the control group, and the difference was statistically significant (P<0.05). The time for blood glucose to reach the standard and the time for urine ketone to turn negative in the observation group were shorter than those in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). [作者简介]徐慧（1987-），女，本科，主治医师，研究方向为急危重症方面。

DOI：10.16658/ki.1672-4062.2022.20.179分析乌司他丁联合胰岛素泵治疗糖尿病酮症酸中毒患者的临床价值周义翰福建医科大学附属闽东医院急诊科，福建宁德355000[摘要]目的分析糖尿病酮症酸中毒患者应用胰岛素泵同乌司他丁联合治疗的临床效果。

方法选取2019年11月—2021年11月期间福建医科大学附属闽东医院收治的80例糖尿病酮症酸中毒患者为研究对象，按单双号方法分组，对照组40例患者使用胰岛素泵单一治疗，观察组40例患者使用乌司他丁联合胰岛素泵治疗。

比较两组炎性相关指标、酸中毒指标、治疗总有效率。

结果治疗后观察组CRP（3.46±0.92）mg/L、TNF-α（1.27±0.31）ng/mL、Lp-PLA2（158.72±19.24）μg/L、HMGB1（3.79±1.12）ng/mL低于对照组，差异有统计学意义（t=6.061、11.112、14.758、6.424，P<0.05）。

观察组CO2CP（22.41±5.63）mmol/L高于对照组，Lac（3.71±0.67）mmol/L低于对照组、pH值纠正时间（1.56±0.42）h、尿酮体转阴时间（25.53±7.17）h均短于对照组，差异有统计学意义（t=2.783、8.947、8.021、8.521，P<0.05）。

观察组治疗总有效率97.50%高于对照组，差异有统计学意义（χ2=6.134，P<0.05）。

结论使用乌司他丁联合胰岛素泵治疗糖尿病酮症酸中毒患者，能够对各项临床指标起到良好的改善效果，总体疗效突出，值得普及。

[关键词] 糖尿病酮症酸中毒；乌司他丁；胰岛素泵；临床疗效[中图分类号] R587 [文献标识码] A [文章编号] 1672-4062（2022）10（b）-0179-04Analysis of the Clinical Value of Ulinastatin Combined with Insulin Pump in the Treatment of Patients with Diabetic KetoacidosisZHOU YihanDepartment of Emergency Medicine, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian Prov⁃ince, 355000 China[Abstract] Objective To analyze the clinical effect of applying insulin pump with ulinastatin combination therapy in patients with diabetic ketoacidosis. Methods 80 patients with diabetic ketoacidosis admitted to Mindong Hospital af⁃filiated to Fujian Medical University during November 2019 to November 2021 were selected as the study subjects. Grouped according to the single and double number grouping method, 40 patients in the control group were treated with insulin pump monotherapy, and 40 patients in the observation group were treated with ulinastatin combined with insulin pump. Compare the inflammation-related indexes, acidosis indexes, and total efficiency of treatment between the two groups. Results After treatment, CRP (3.46±0.92) mg/L, TNF-α (1.27±0.31) ng/mL, Lp-PLA2 (158.72±19.24) μg/L, HMGB1 (3.79±1.12) ng/mL in the observation group were lower than those in the control group, and the differences were statistically significant (t=6.061, 11.112, 14.758, 6.424, P<0.05). CO2CP (22.41±5.63) mmol/L was higher, Lac (3.71±0.67) mmol/L was lower, pH correction time (1.56±0.42) h, and urinary ketone body conversion time (25.53±7.17) were shorter in the observation group than in the control group, and the differences were statistically sig⁃nificant (t=2.783, 8.947, 8.021, 8.521, P<0.05). The total effective rate of treatment in the observation group was 97.50% higher than that in the control group, and the difference was statistically significant (χ2=6.134, P<0.05).Conclusion The use of ulinastatin combined with insulin pump in the treatment of diabetic ketoacidosis patients can play a good role in improving various clinical indicators, and the overall efficacy is outstanding and worth popularizing. [作者简介]周义翰（1975-），男，本科，副主任医师，研究方向为急救医学。

胰岛素泵治疗急诊糖尿病酮症酸中毒的疗效分析糖尿病是一种慢性疾病，如果不得到有效的控制，会带来许多严重的并发症，其中包括糖尿病酮症酸中毒。

糖尿病酮症酸中毒是糖尿病急性并发症之一，是由于血糖过高、胰岛素不足导致机体脂肪代谢紊乱，产生大量酮体，导致血液酸碱平衡失调，出现酸中毒的一种严重情况。

胰岛素泵是一种用于糖尿病患者持续输注胰岛素的设备，可以更好地模拟胰岛素分泌的生理过程，帮助糖尿病患者更好地控制血糖水平。

在急诊糖尿病酮症酸中毒的治疗中，胰岛素泵的应用是否能够取得良好的疗效呢？本文将对胰岛素泵治疗急诊糖尿病酮症酸中毒的疗效进行分析。

胰岛素泵是一种通过皮下置入导管输注胰岛素的设备，它可以模拟人体自然胰岛素的分泌方式，使得胰岛素的输注更为精准和及时。

在急诊糖尿病酮症酸中毒的治疗中，胰岛素泵可以根据患者的血糖水平实时调整胰岛素的输注量，帮助维持患者的血糖在正常范围内，避免过高的血糖导致酮症酸中毒的发生。

胰岛素泵的优势在于可以提供更为精准的胰岛素输注，避免出现血糖波动过大的情况，从而更好地控制糖尿病酮症酸中毒的发生。

胰岛素泵可以根据患者的饮食和运动情况进行智能调整，更好地满足不同患者的治疗需求。

在临床实践中，胰岛素泵已经被广泛应用于糖尿病的治疗中，并取得了良好的效果。

在急诊糖尿病酮症酸中毒的治疗中，胰岛素泵同样被用于减少血糖的波动，提供更为稳定的胰岛素输注，帮助患者尽快摆脱酮症酸中毒的困扰。

胰岛素泵还可以提供24小时的胰岛素输注，保持持续的胰岛素覆盖，确保患者在饮食和运动等情况下也能维持稳定的血糖水平。

这对于急诊糖尿病酮症酸中毒的治疗尤为重要，可以有效避免血糖的波动引起酮症酸中毒的加重。

胰岛素泵治疗急诊糖尿病酮症酸中毒的疗效已经得到了临床的验证和认可。

研究表明，胰岛素泵可以显著降低患者的血糖水平，缩短酮症酸中毒的持续时间，减少并发症的发生。

特别是对于一些难治性糖尿病患者，胰岛素泵可以提供更为个性化的治疗方案，更好地满足患者的治疗需求。