糖尿病患者腹部手术围术期不同胰岛素治疗方案的疗效分析

目的探讨合并糖尿病的腹部手术患者围术期控制血糖的有效方法。方法将66例2型糖尿病腹部手术围术期患者分成二组，观察组（30例）：给予三餐前皮下注射诺和灵R＋胰岛素微量泵持续静滴；对照组（36例）；给予三餐前皮下注射诺和灵R＋22；00皮下注射诺和灵N。比较二组血糖迭标时间、胰岛素每日剂量、低血糖发生率及并发症情况。结果观察纽血糖迭标时间、胰岛素每日剂量、低血糖发生率及并发症情况明显优于对照组，差异有统计学意义（P〈0．05）。结论三餐前皮下注射诺和灵R＋胰岛素微量泵持续静脉输注在围术期是较合理的胰岛素强化治疗方案，值得推广。

Reseach on the effect of different insulin treatment methods on patients with diabetes in perioperative period of abdominal surgery

Objective To investigate the effective methods which can control the blood glucose of patients with diabetes in perioperative period of abdominal surgery. Methods 66 patients with type 2 diabetes in perioperative period of abdominal surgery were randomly divided into two groups. The experimental group （n = 30） was treated with Novolin R before three meals by subcutaneous injections and continuing intravenous insulin infusion with minipump. The control group（n = 36） was treated with Novolin R before three meals and Novolin N at 22：00 by subcutaneous injections. The standard time of blood glucose for achieving the target, daily insulin dose, incidence of hypoglycaemia and complications were compared between the two groups. Results The standard time of blood glucose for achieving the target, daily insulin dose, incidence of hypoglycaemia and complications in experimental group were better than that of control group after the treatment and the differences were significant （P〈0.05）. Conclusion Treatment with Novolin R before three meals by subcutaneous injections and continuing intravenous insulin infusion with minipump to diabetes patients in perioperative period of abdominal surgery is a more reasonable intensive insulin therapy which is worthy of promotion.