门诊多次胰岛素皮下注射强化治疗难治性糖尿病临床观察.docVIP

门诊多次胰岛素皮下注射强化治疗难治性糖尿病临床观察 　　[摘要] 目的 观察门诊患者胰岛素强化治疗对高血糖控制的影响，从而探索难治性糖尿病血糖达标的门诊管理方案。方法 选择2011年5月～2015年6月在本院住院的62例难治性糖尿病患者，出院时血糖基本达标。其中34例为治疗组，出院后继续在门诊维持胰岛素强化治疗，其余28例为对照组，出院后使用口服药物或者2次预混胰岛素治疗。治疗3个月后比较两组患者的血糖控制达标率、低血糖发生事件等情况。 结果 与对照组比较，强化治疗组FPG、2hPG及HbA1c指标控制更平稳（P0.05），血糖达标率更高（P0.05），低血糖事件发生率更低（P0.05）。 结论 多次皮下胰岛素注射强化治疗是难治性糖尿病患者有效、安全的治疗方案，并且此方案适宜在门诊管理和推广。 　　[关键词] 胰岛素注射；强化治疗；难治性糖尿病；门诊管理 　　[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701（2015）34-0028-03 　　Clinical observation of multiple subcutaneous insulin injection in the intensive treatment of refractory diabetes in outpatient clinics 　　YANG Jun TANG Li 　　Department of Endocrinology， Xuanen County Peoples Hospital in Hubei Province Xuanen 445500， China 　　[Abstract] Objective To observe the effects of insulin intensive treatment on the control of hyperglycemia in the patients in outpatient clinics， so as to explore the management protocol of blood glucose up to standard in refractory diabetes. Methods A total of 62 patients with refractory diabetes who were hospitalized in our hospital from May 2011 to June 2015 were selected， and their blood glucose level was basically up to standard upon discharge. 34 of them were in treatment group， were further given maintenance intensive insulin therapy in the Outpatient Clinic after discharge， and 28 of them were in the control group， who were given oral medication or 2 times of pre-mixed insulin therapy. The standard rate of blood glucose control and events of hypoglycemia were compared between the two groups of patients 3 months after the treatment. Results There was statistical significance in the comparison between intensive treatment group and control group. The control of FPG， 2hPG and HbA1c indicators was more stable（P0.05）， the standard rate of blood glucose was higher（P0.05） and the incidence rate of hypoglycemia was lower （P0.05）. Conclusion Intensive treatment of multiple subcutaneous insulin injection is an effective and safe treatment protocol for patients with refrac