摘要
目的：观察ICU危重病患者应激性高血糖胰岛素强化治疗的临床疗效。方法：110例ICU病房的危重病患者随机分为胰岛素强化治疗组（n=55）和对照组（n=55），强化治疗组血糖控制在4．4～6．1mmol／L，对照组血糖控制在10．0～11．1mmol／L，观察两组患者ICU住院天数、需机械通气例数、机械通气天数、院内感染发生率、抗生素应用天数、ICU最后1d APACHEⅡ评分、低血糖发生率、多器官功能衰竭发生率、病死率等。结果：治疗组ICU住院天数、需机械通气例数、机械通气天数、院内感染发生率、抗生素应用天数、ICU最后1d APACHEⅡ评分、多器官功能衰竭发生率、病死率均明显低于对照组（P〈0．05或P〈0．01），低血糖发生率则高于对照组（P〈0．05）。结论：危重病患者应激性高血糖胰岛素强化治疗，控制血糖在4．4～6．1mmol／L水平，可改善临床疗效、降低病死率。
Objective To observe the effect of intensive insulin therapy on the critically ill patients with stress hyperglycemia in ICU. Methods One hundred and ten critically ill patients in ICU were randomly divided into two groups, the intensive insulin therapy group （n=55） and control group （n= 55）. The blood glucose in the intensive insulin therapy group was controlled at 4.4 to 6.1 mmol/L, and the blood glucose in control group was controlled at 10.0 to 11.1 mmol/L. The two groups were observed and compared the days in the ICU, the numbers of patients requiring mechanical ventilation, the days of mechanical ventilation, the incidences of infection in hospital, the days of using antibiotics, Acute Physiology and Chronic Health Evaluation Ⅱ score of the last day in ICU, the morbidity of multiple organ failure, the morbidity of hypoglycemia and mortality. Results All the above indices except morbidity of hypoglycemia were significantly lower in the intensive insulin therapy group than those in control group （P〈0. 05 or P〈0. 01）. Conclusion Intensive insulin therapy and keeping blood glucose at 4.4 to 6.1 mmol/L can improve the clinical curative effect and reduce the mortality for the critically ill patients with stress hyperglycemia.
出处
《中华实用诊断与治疗杂志》
2008年第9期677-678,683,共3页
Journal of Chinese Practical Diagnosis and Therapy
