摘要
目的探讨不同剂量胰岛素在小儿糖尿病酮症酸中毒中的临床应用价值。方法选择2020年1月—2021年4月该院收治的糖尿病发生酮症酸中毒患儿80例为研究对象。按照随机数表法分为两组,各40例。所有患儿入组后均行对症支持处理,联合血钾水平调节,胰岛素使用上,观察组使用小剂量胰岛素注射液0.05~0.10 U/(kg·h),对照组使用大剂量胰岛素实施冲击治疗0.1~0.2 U/(kg·h),比较两组干预前后糖化血红蛋白、空腹血糖及餐后2 h血糖水平变化,比较两组干预前后电解质(血钠和血钾)水平变化,统计两组酸中毒纠正时间和尿酮体转阴时间及治疗期间并发症发生情况。结果观察组糖化血红蛋白、空腹血糖及餐后2 h血糖水平低于同期对照组,差异有统计学意义(P<0.05),观察组血钠水平高于对照组,差异有统计学意义(P<0.05),血钾水平低于对照组,差异有统计学意义(P<0.05),观察组酸中毒纠正时间和尿酮体转阴时间均显著早于对照组,差异有统计学意义(P<0.05),观察组发生高渗性昏迷、低血压和低血糖的总比例显著低于对照组,差异有统计学意义(P<0.05)。结论针对糖尿病酮症酸中毒小儿,使用小剂量胰岛素相对大剂量胰岛素,其能更快地控制血糖稳定,促进尿酮体转阴,维持电解质平稳,且并发症少,安全性高。
Objective To explore the clinical application value of different doses of insulin in children with diabetic ketoacidosis.Methods From January 2020 to April 2021,80 children with diabetes and ketoacidosis who were admitted to the hospital were selected as the research objects.According to the random number table method,they were divided into two groups,each with 40 cases.All children were treated with symptomatic and supportive treatment,combined with blood potassium level adjustment,and insulin use.The observation group was treated with low-dose insulin injection 0.05~0.10 U/(kg·h),and the control group was treated with high-dose insulin for shock therapy 0.1~0.2 U/(kg·h),compare the changes of glycosylated hemoglobin,fasting blood glucose and blood glucose level 2 h after the intervention of the two groups before and after the intervention,compare the changes of electrolyte(blood sodium and potassium)levels of the two groups before and after the intervention,and calculate the acidity time to correct the poisoning,the time for urinary ketones to become negative,and the complications that occurred during the treatment of the two groups.Results The levels of glycosylated hemoglobin,fasting blood glucose and 2 h postprandial blood glucose in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The blood sodium level of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05),and the blood potassium level was lower than that of the control group,and the difference was statistically significant(P<0.05),the time to correct acidosis and the time for urinary ketones to become negative in the observation group were significantly earlier than those in the control group,and the difference was statistically significant(P<0.05).The total proportion of hyperosmolar coma,hypotension and hypoglycemia in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For children with diabetic ketoacidosis,the use of low-dose insulin relative to high-dose,insulin can control faster blood glucose,promote urinary ketone body to become negative,maintain electrolyte stability,and have fewer complications and high safety.
作者
吴晓旭
WU Xiaoxu(Department of Pediatrics,West China Guang'an Hospital,Sichuan University,Guang'an,Sichuan Province,638000 China)
出处
《糖尿病新世界》
2021年第18期6-9,共4页
Diabetes New World Magazine
关键词
胰岛素
小儿
糖尿病
酮症酸中毒
血钾水平
Insulin
Children
Diabetes
Ketoacidosis
Blood potassium level
