持续皮下胰岛素输注在糖尿病患者围手术期应用价值评估.doc

持续皮下胰岛素输注在糖尿病患者围手术期应用价值评估 　【关键词】 胰岛素；注射,皮下；手术期间 　　Value of continuous subcutaneous insulin infusion during perioperation of diaketic patients 　　【Abstract】 AIM: To assess the effect of continuous subcutaneous insulin infusion (CSII) during perioperation in diabetic patients. METHODS: Eightyseven diabetic patients in perioperation who need insulin therapy were randomly divided into CSII group (n=46, 2 T1DM and 44 T2DM) and multiple subcutaneous insulin infusion (MSII) group (n=41, 3 T1DM and 38 T2DM). The target of blood glucose control was 3.9-7.9 mmol/L. The time of blood glucose for achieving the target, and preoperative preparation time, length of stay, success rate of preoperative blood glucose control, glucose level at 3 rd day of insulin treatment, expense for preoperative glucose control and total expense of hospitalization were compared between the 2 groups. RESULTS: The time of blood glucose for achieving the target in CSII group［(2.2±1.6)d］was shorter than that in MSII group［(8.5±4.8) d, Plt;0.01］;the time of preoperative preparation in CSII group ［(4.6±3.2) d］ was shorter than that in MSII group ［(11.8±6.8) d, Plt;0.01］; the length of stay in CSII group［(19.6±9.4) d］was also shorter than that in MSII ［(26.2±10.0) d, Plt;0.01］;the success rate of preoperative blood glucose control in CSII group was 85.4%, higher than that in MSII (53.2%, Plt;0.01). Fasting glucose level at 3 rd day of insulin treatment in CSII group ［(7.5±1.8) mmol/L］ was lower than that in MSII ［(10.5±2.6) mmol/L, Plt;0.01］. All of above results proved that CSII could help to obtain better glucose control. Although expense for preoperative glucose control in CSII group ［(867.9±574.4) RMB］ was higher than that in MSII ［(497.9±283.6) RMB, Plt;0.01］, total expense of hospitalization in CSII group ［(25007±18048) RMB］ was almost as much as that in MSII ［(24919±21617)RMB, Pgt;0.05). CONCLUSION: The application of CSII in preoperation of diabetic patients can bring better glucose control and shor