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参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖的临床观察
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| 篇名： | 参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖的疗效。方法： 回顾性收集156例脓毒症且确诊为应激性高血糖患者资料，按用药不同分为对照组（78例）和观察组（78例）。所有患者及时确定病原菌并给予相应的抗感染治疗、改善通气状态、给予充分液体复苏支持、适当给予免疫治疗和营养支持等常规治疗；在此基础上，对照组患者按不同的血糖水平给予不同剂量的胰岛素[1 U/ml，静脉微量泵入，速度为0.1 U/（kg·h）]；观察组患者在对照组治疗的基础上加用参脉注射液40 ml，加入胰岛素混合溶液中，静脉微量泵入。观察两组患者终点事件、血糖达标时间、胰岛素总用量、基础指标[急性生理与慢性健康（24 APACHE-Ⅱ）评分、机械通气时间、ICU住院天数、低血糖发生例次]及不良反应发生情况。结果：观察组患者终点事件总发生率显著低于对照组，血糖达标时间显著短于对照组，胰岛素总用量显著少于对照组，机械通气时间显著短于对照组，ICU住院时间显著少于对照组，差异均有统计学意义（P＜0.05）；治疗前，两组患者24 APACHE-Ⅱ评分差异无统计学意义（P＞0.05）；治疗后，两组患者24 APACHE-Ⅱ评分显著降低，且观察组低于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗期间均未见明显不良反应发生。结论：在常规治疗的基础上，参麦注射液联合胰岛素强化治疗脓毒症患者应激性高血糖疗效较好，能减少达标血糖所用时间胰岛素总用量，降低终点事件总发生率和24 APACHE-Ⅱ评分，缩短机械通气时间、减少ICU住院天数，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe the efficacy of Shenmai injection combined with insulin in the intensive treatment of stress hyperglycemia in the septicopyemia patients. METHODS： The data of 156 septicopyemia patients with stress hyperglycemia was collected Retrospectively，according to the different medication divided into control group （78 cases） and observation group （78 cases）.All patients determined the pathogenic bacteria and received related anti-infection treatment， improving ventilation state， adequate fluid resuscitation support， immune therapy， nutritional support and other conventional treatment； based on it， control group received different dosages of insulin [1 U/ml， intravenous micro pump， with speed of 0.1 U/（kg·h）] based on different blood glucose levels； observation group additionally received 40 ml Shenmai injection， adding into insulin mixed solution， intravenous micro pump. Endpoint events（mortality）， recovering time of blood glucose， total dosage of insulin， basic indicators [Acute physiology and chronic health （24 APACHE-Ⅱ） score， mechanical ventilation time， hospitalization days in ICU and frequency of hypoglycaemia] and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total mortality rate in observation group was significantly lower than control group， recovering time of blood glucose was significantly shorter than control group， the total dosage of insulin was significnatly less than control group， mechanical ventilation time was significantly shorter than control group，hospitalization days in ICU was significantly less than control group，the differences were statistically significant （P＜0.05）.before treatment， there were no significant differences in the 24 APACHE-Ⅱ score in 2 groups （P＞0.05）； after treatment， the 24 APACHE-Ⅱ score in 2 groups were significantly reduced， and observation group was lower than control group， the differences were statistically significant （P＜0.05）. And there were no obvious adverse reactions in 2 groups during treatment. CONCLUSIONS： Based on conventional treatment， Shenmai injection combined with insulin shows good efficacy in the intensive treatment of stress hyperglycemia in the septicopyemia patients， it can decrease total dosage of insulin， reduce mortality rate and 24 APACHE-Ⅱ score， shorten mechanical ventilation time and decrease hospitalization days in ICU，with good safety. |
| 期刊： | 2016年第27卷第24期 |
| 作者： | 孙良，李丕宝，孙先义 |
| AUTHORS： | SUN Liang，LI Pibao，SUN Xianyi |
| 关键字： | 参麦注射液；胰岛素；脓毒症；应激性高血糖；死亡率；急性生理与慢性健康评分 |
| KEYWORDS： | Shenmai injection； Insulin； Stress hyperglycemia； Septicopyemia； Mortality rate； APACHE-Ⅱ score |
| 阅读数： | 709 次 |
| 本月下载数： | 1 次 |
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