Objective To observe the clinical efficacy of intensive insulin therapy for critical patients with stress hypergiycemia (SHG). Methods Eighty patients with SHG were randomly divided into two groups, namely intensive insulin therapeutic group (intensive group, 40 cases) and conventional therapeutic group (conventional group, 40 cases). In the intensive group, when blood sugar was higher than 6.1 mmol/L, intravenous drip of insulin 1-2 U/h with micro-venous pump was used to maintain the blood sugar at 4.4-6.1 mmol/L in 24 hours, In the conventional group, when blood sugar was higher than 11.7 mmol/L, intravenous drip of insulin 1-2 U/h was given to maintain the blood sugar level at 10.0-11.1 mmol/L in 24 hours. The limes of insulin infusion, hospitalization lime, the rates of hospital infection and fatality were compared between the two groups after 4 weeks of therapy. Results On rnstatistical significance (16.93±4.32 vs. 16.78± 4.40, P＞0.05). The insulin infusing time [ (8.6±2.4) days], hospitalizalion time [(10.2±4.6) days;, hospital infection rate (5%) and fatality rate (2.5%) in intensive group were significantly improved compared with those in the conventional group [(14.2 ± 3.2) days, (15.6 ± 5.4) Gays, 15%, 1.5%}, the differences being statistically significant (all P＜0.05). Conclusion Intensive insulin therapy has remarkable clinical effect on controlling high blood sugar, reducing rates of infection and fatality.%目的 观察强化胰岛素治疗危重症患者应激性高血糖(SHG)的临床疗效.方法 80例危重症SHG患者按随机原则分为强化胰岛素治疗组(强化治疗组)和常规治疗组,每组40例.强化治疗组血糖＞6.1 mmol/L时,采用微量泵静脉滴注(静滴)胰岛素1～2 U/h,在24 h内使血糖维持在4.4～6.1 mmol/L;常规治疗组血糖＞11.7 mmol/L时,静滴胰岛素1～2 U/h,在24 h内使血糖维持在10.0～11.1 mmol/L.治疗4周后,比较两组患者泵入胰岛素时间、住院时间、院内感染率、病死率.结果 强化治疗组和常规治疗组入院时血糖值(mmol/L)比较差异无统计学意义(16.93±4.32比16.78±4.40,P＞0.05).强化治疗组泵入胰岛素时间[(8.6±2.4) d]、住院时间[(10.2±4.6) d]、院内感染率(5%)、病死率(2.5%)较常规治疗组[(14.2±3.2) d、(15.6±5.4) d、15%、7.5%]明显改善,差异均有统计学意义(均P＜0.05).结论 强化胰岛素治疗可控制高血糖,减少感染发生率,降低病死率,临床疗效显著.
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