CGMS联合胰岛素强化治疗ICU高血糖危重患者的临床效果研究

摘要

Objective:To observe the clinical effect of continuous glucose monitoring system (CGMS) and intensive insulin therapy on ICU critical patients with hyperglycemia.Methods:A total of 135 ICU critical patients with hyperglycemia were randomly divided into control group (n =67) and observation group (n =68).Control group was treated with conventional fingertip blood glucose monitoring and insulin therapy,observation group was treated with CGMS combined with intensive insulin therapy.FBG values of different periods,ICU length of stay,average duration of mechanical ventilation,mortality,the incidence of hypoglycemia were observed.Results:FBG values in observation group was lower than that in the control group after 3,5,7 days treatment,difference was statistically significant (P ＜ 0.05).ICU length of stay,the average duration of mechanical ventilation in the observation group were shorter than that in the control group and mortality was lower than that in the control group,but the difference was not significant (P ＞ 0.05).The incidence of hypoglycemia in the observation group was lower than that in the control group,the difference was statistically significant (P＜0.05).Conclusion:CGMS combined with intensive insulin therapy is helpful to grasp the changes of blood glucose in ICU critical patients with hyperglycemia,and formulate the amount of insulin more sicentifically,can reduce blood glucose quickly and reduce the incidence of hypoglycemia,has good clinical efficacy,deserves to be widely used in clinic.%目的:观察动态血糖监测(CGMS)联合胰岛素强化治疗重症监护室(ICU)高血糖危重患者的临床效果.方法:选择我院重症监护室收治的高血糖危重患者135例,随机分为对照组(n=67)和观察组(n=68).对照组行指尖血糖监测联合胰岛素常规治疗;观察组行CGMS联合胰岛素强化治疗.观察2组患者在不同时段的FBG值、ICU住院时间、平均机械通气时间、病死率、低血糖发生情况.结果:观察组的FBG值在治疗第3、5、7天均比对照组低,差异有统计学意义(P＜0.05);观察组的ICU住院时间、平均机械通气时间均比对照组短,病死率也比对照组低,但差异无统计学意义(P＞0.05);观察组的低血糖发生次数及发生率均比对照组低,差异有统计学意义(P＜0.05).结论:CGMS联合胰岛素强化治疗有助于更精准地掌握高血糖危重患者的血糖变化情况,进而更科学地制定胰岛素的使用量,快速降低患者的血糖并减少低血糖的发生率,具有很好的临床疗效,值得加以推广.