不同胰岛素给药方法治疗糖尿病合并脑卒中的临床效果观察
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摘要
目的:观察不同胰岛素给药方法治疗糖尿病合并脑卒中的临床效果。方法:选取2017年10月—2018年9月治疗的糖尿病合并脑卒中患者126例,应用随机数字表法分为观察组和对照组,每组63例。对照组接受胰岛素多次皮下注射(MSII)治疗,观察组接受胰岛素泵持续皮下注射(CSII)治疗。观察两组血糖达标时间、血糖水平及美国国立卫生研究院卒中量表(NIHSS)评分、barthel指数(BI)评分、同型半胱氨酸、血脂、血压及并发症等。结果:与对照组相比,观察组血糖达标时间较短,平均血糖水平较低,两组比较,差异有统计学意义(P <0. 05)。治疗前两组NIHSS评分、BI评分比较,差异无统计学意义(P> 0. 05);治疗后观察组NIHSS评分较低,BI评分较高,两组比较,差异有统计学意义(P <0. 05)。治疗前后两组同型半胱氨酸、血脂及血压相关指标对比,差异均无统计学意义(P> 0. 05)。治疗后观察组并发症发生率为9. 52%,低于对照组,两组比较,差异有统计学意义(P <0. 05)。结论:相对于MSII而言,CSII为糖尿病合并脑卒中患者治疗中较为安全有效的方法,利于控制血糖水平且并发症少,可加快神经功能及日常生活能力恢复。
Objective: To observe the clinical effects of different insulin administration methods in treatment of diabetes combined with stroke. Methods: All 126 patients with diabetes combined with stroke treated in the hospital from October 2017 to September 2018 were selected,and they were divided into two groups by random number table,with 63 cases in each group.Control group was given multiple subcutaneous insulin injection( MSII),while observation group was treated with continuous subcutaneous insulin infusion( CSII). The standard time of blood glucose,level of blood glucose,National Institutes of Health Stroke Scale( NIHSS) score,Barthel index( BI),homocysteine,blood lipid,blood pressure,complications in the two groups were observed. Results: Compared with control group,the standard time of blood glucose of observation group in observation group was shorter,and the average level of blood glucose in observation group was lower( P < 0. 05). Before treatment,there was no statistical difference in the NIHSS and BI scores between the two groups( P > 0. 05). After treatment,compared with control group,the NIHSS score of observation group was lower,while the BI score of observation group was higher( P < 0. 05).There was no statistical difference in the homocysteine,blood lipid,blood pressure between the two groups before and after treatment( P > 0. 0 5). The incidence of complications in observation group( 9. 5 2 %) was lower than that in control group( P < 0. 05). Conclusion: CSII in treatment of patients with diabetes and stroke is more safe and effective than MSII,it can control the level of blood glucose,achieve less complications,promote recovery of nerve function and activity of daily living.
Objective: To observe the clinical effects of different insulin administration methods in treatment of diabetes combined with stroke. Methods: All 126 patients with diabetes combined with stroke treated in the hospital from October 2017 to September 2018 were selected,and they were divided into two groups by random number table,with 63 cases in each group.Control group was given multiple subcutaneous insulin injection( MSII),while observation group was treated with continuous subcutaneous insulin infusion( CSII). The standard time of blood glucose,level of blood glucose,National Institutes of Health Stroke Scale( NIHSS) score,Barthel index( BI),homocysteine,blood lipid,blood pressure,complications in the two groups were observed. Results: Compared with control group,the standard time of blood glucose of observation group in observation group was shorter,and the average level of blood glucose in observation group was lower( P < 0. 05). Before treatment,there was no statistical difference in the NIHSS and BI scores between the two groups( P > 0. 05). After treatment,compared with control group,the NIHSS score of observation group was lower,while the BI score of observation group was higher( P < 0. 05).There was no statistical difference in the homocysteine,blood lipid,blood pressure between the two groups before and after treatment( P > 0. 0 5). The incidence of complications in observation group( 9. 5 2 %) was lower than that in control group( P < 0. 05). Conclusion: CSII in treatment of patients with diabetes and stroke is more safe and effective than MSII,it can control the level of blood glucose,achieve less complications,promote recovery of nerve function and activity of daily living.
引文
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[7]王岫峥,董丽娜.胰岛素不同给药方式治疗肺结核合并2型糖尿病的临床观察[J].临床肺科杂志,2017,22(12):2226-2229.
[8]董瑾,赵彦,黄乐.胰岛素不同给药方法治疗儿童1型糖尿病的效果观察[J].天津医药,2015,43(8):889-891.
[9]胡冰,张芳.比较胰岛素泵与多次胰岛素皮下注射强化治疗2型糖尿病合并脑卒中的临床价值[J].国际检验医学杂志,2015,36(22):3240-3242.
[10]刘斐,姚杰,马琴琴,等.胰岛素不同给药方式治疗糖尿病酮症酸中毒患者高血糖的疗效[J].宁夏医科大学学报,2017,39(1):72-74.
[11]高红兰,施耀方,邹建英. 722实时动态胰岛素泵在糖尿病合并脑卒中患者中的运用[J].实用老年医学,2015,29(11):964-966.
[12]冯静,王新玲,李红艳,等.胰岛素两种给药方式对高龄妊娠期糖尿病患者相关指标的影响比较[J].中国药房,2017,28(15):2032-2035.
[2]韩荣荣,唐爱奇,方杭燕,等. 2型糖尿病患者并发脑卒中的前瞻性研究[J].浙江预防医学,2017,29(2):139-141.
[3]钱丽雅,钱科威,李红,等. 2型糖尿病肺部感染患者胰岛素不同方法治疗的疗效分析[J].中华医院感染学杂志,2015,25(11):2510-2512.
[4]李素梅,林国新,陈金星,等. 2型糖尿病酮症患者消酮期与消酮后期不同胰岛素治疗方式对胰岛功能的影响[J].中国糖尿病杂志,2015,23(3):230-232.
[5]张玲晓,吴文俊,詹伟彬.双时相门冬胰岛素不同给药方案对血糖控制不佳2型糖尿病患者相关指标的影响[J].中国药房,2015,26(33):4644-4646.
[6]霍文艳,杨立清,任春秀,等.蒙古族2型糖尿病合并脑卒中患者相关危险因素及其基因多态性的研究[J].中国糖尿病杂志,2017,25(6):507-510.
[7]王岫峥,董丽娜.胰岛素不同给药方式治疗肺结核合并2型糖尿病的临床观察[J].临床肺科杂志,2017,22(12):2226-2229.
[8]董瑾,赵彦,黄乐.胰岛素不同给药方法治疗儿童1型糖尿病的效果观察[J].天津医药,2015,43(8):889-891.
[9]胡冰,张芳.比较胰岛素泵与多次胰岛素皮下注射强化治疗2型糖尿病合并脑卒中的临床价值[J].国际检验医学杂志,2015,36(22):3240-3242.
[10]刘斐,姚杰,马琴琴,等.胰岛素不同给药方式治疗糖尿病酮症酸中毒患者高血糖的疗效[J].宁夏医科大学学报,2017,39(1):72-74.
[11]高红兰,施耀方,邹建英. 722实时动态胰岛素泵在糖尿病合并脑卒中患者中的运用[J].实用老年医学,2015,29(11):964-966.
[12]冯静,王新玲,李红艳,等.胰岛素两种给药方式对高龄妊娠期糖尿病患者相关指标的影响比较[J].中国药房,2017,28(15):2032-2035.