ICU患者胰岛素泵治疗过程中使用实时动态血糖监测的价值分析

摘要

Objective To investigate and analyze the value of using real time dynamic blood sugar monitoring during insulin pump treatment process in ICU patients.Methods Sixty-two ICU cases needing insulin intervention due to own blood glucose abnormality in this hospital from February 2015 to February 2016 were selected and divided into the control group and observation group,31 cases in each group.The control group used the fingertip method for measuring blood glucose and simultaneously used the continuous intravenous insulin injection by micropump;the observation group used real time dynamic blood sugar monitoring system to measure blood glucose level.Results The two groups completed the related study without excluded case or fallen out case.The observation group was better than the control group in the aspects of the time reaching target blood sugar level,total treatment time,insulin dosage and hypoglycemia occurrence rate,the difference was statistically significant (P ＜ 0.05).MBG,MAGE,MODD,SDBG and time percent of glucose drift (TBG≥7.8 mmol/L and TBG≤3.9 mmol/L) on 3 d in the observation group were significantly decreased compared with those on 1 d.The two monitoring methods showed significantly positive correlation (r =0.97,P=0.006).Conclusion ICU patients using the real time dynamic blood sugar monitoring system can obviously decrease blood sugar level,and is safe and effective.%目的 探讨重症监护室(ICU)患者胰岛素泵治疗过程中使用实时动态血糖监测的价值.方法 本研究选取2015年2月至2016年2月该院ICU收治的62例由于自身血糖出现异常,需要使用胰岛素进行干预治疗的患者.将患者分为对照组和观察组,各31例.对照组使用指尖法进行血糖测定,同时使用微量泵将胰岛素持续注入静脉中进行治疗;观察组使用实时动态血糖监测系统对血糖进行测定.结果 两组患者均完成相关研究,无剔除和脱落患者.在达到目标血糖水平的时间、治疗总时间、胰岛素用量和低血糖发生率方面,观察组均优于对照组,差异有统计学意义(P＜0.05);观察组患者第3天时的日内平均血糖(MBG)、日内平均血糖波动幅度(MAGE)日间血糖平均绝对差(MODD)、血糖水平标准差(SDBG)及血糖漂移时间百分比(TBG≥7.8 mmol/L及TBG≤3.9 mmol/L)均较第1天显著下降(P＜0.05);两种监测方法呈显著的正相关性(r=0.97,P=0.006).结论 ICU患者使用实时动态血糖监测系统,能够显著降低患者的血糖水平,安全有效.