T2DM患者静点葡萄糖-胰岛素溶液对血糖影响的研究-护理学专业论文.docxVIP

— — PAGE 1— 摘 要 T2DM 患者静点葡萄糖-胰岛素溶液 对血糖影响的研究 研究生：刘安诺 导师：彭巧君主任护师 摘 要 目的：探讨 T2DM 患者静脉点滴葡萄糖胰岛素溶液血糖是否保持平稳及影响平 稳的相关因素。方法：采用自身前后配对设计，对 172 名 T2DM 患者在 7d 观察期内 给予等量、同药物输液治疗，第 2、3 天 0.9%氯化钠注射液 250ml，第 4、5 天 5%葡 萄糖 250ml+RI 4u，第 6、7 天以 5%葡萄糖 250ml+RI 6u 为溶剂。观察输液前后血糖 的变化。结果：1）5%葡萄糖液+4uRI 为溶剂输注过程发生血糖升高的患者与 0.9% 氯化钠液比较差异有统计学意义；0.9%氯化钠液与 5%GS+4uRI 结束、结束 2h 的血 糖水平比较有统计学意义；2）5%GS+4uRI 与 5%GS+6uRI 结束、结束 2h 血糖水平 比较有统计学意义；3）血糖升高单因素分析与年龄、病程、糖化血清蛋白、腹围、 并发症、治疗模式、民族相关；Logistic 回归分析与糖化血清白、民族、BMI 有关。 结论：1）T2DM 患者输注 5%葡萄糖 250ml+4u RI，输液过程有 40.70%患者血糖升 高；2）T2DM 患者液体治疗最好选择 0.9%氯化钠溶液作为药物的溶剂，滴速控制在 50～60gtt/min 以减少容量负荷；3）影响血糖平稳的主要因素：民族、糖化血清蛋白 症、BMI。输注葡萄糖液应参考上述因素增加外源胰岛素配制。3.护理措施：输液过 程应监测血糖，防止医源性高血糖；控制早餐质和量，输液中间不能再次摄食；个 体化输注胰岛素方案。 关键词：2 型糖尿病；葡萄糖；胰岛素；血糖 新疆医科大学医学硕士学位论文 Matched-pairs design study on Risk Factors forIntravenous infusion Glucose-Insulin in Type 2 Diabetic Patients Postgraduate:LiuAnruo Supervisor: Prof. PengQiaojun Abstract Objective: To investigate whether blood glucose can maintain stable when diabetic was administered with glycol-insulin solutions by intravenous drip and the relative factors to affect its stability.Methods: To choose 172 type-2 diabetic inpatients who received drugs by intravenous treatment as investigating object analyzed by self matched-pairs design.The experiment lasts seven days.250ml 0.9%sodium chloride injection was intravenous infused on the second and third day; 5%glycose solution added with 4u RI on the forth and fifth day; 5%glycose solution added with 6u RI on the sixth and seventh day, Observed changes in blood glucose before and after infusion.Results: 1) The inpatients whose blood glucose at the end was higher than the instant in glycose group with 0.9%sodium chloride, and the comparison had statistical significance; the level of blood glucose at the end and two hours after the end in glycose and in sodium chloride, the comparison had statistical significance.2) The leave of the blood glucose with 4u RI and 6u RI at the end and two hours after the end wa