馮榮學
[摘要] 目的 分析不同劑量胰島素治療小兒糖尿病酮癥酸中毒(DKA)的效果。方法 以2012年1月—2017年12月間入該院治療的24例DKA患兒為研究主體。分成A組和B組,各12例。A組給予小劑量胰島素治療,B組給予大劑量胰島素治療。對比治療效果。 結(jié)果 A組的空腹血糖(FBG)與餐后2 h血糖(PBG)略低于B組,對比差異無統(tǒng)計學意義(P>0.05);A組的血糖達標時間、酮體轉(zhuǎn)陰時間與pH恢復(fù)時間均短于B組,對比差異有統(tǒng)計學意義(P<0.05)。A組的低血糖發(fā)生率低于B組(P<0.05)。治療后,兩組的生化指標均低于治療前,對比差異有統(tǒng)計學意義(P<0.05)。 結(jié)論 為DKA患兒行小、大劑量胰島素治療的降糖效果均較佳,但小劑量胰島素的治療安全性更高,更具有推廣價值。
[關(guān)鍵詞] 不同劑量;胰島素;小兒糖尿病酮癥酸中毒
[中圖分類號] R725 [文獻標識碼] A [文章編號] 1672-4062(2018)10(a)-0075-02
[Abstract] Objective To analyze the effect of different doses of insulin in treatment of children with diabetic ketoacidosis. Methods 24 cases of DKA children treated in our hospital from January 2012 to December 2017 were selected and divided into two groups with 12 cases in each, the group A used the small-dose insulin, while the group B used the large-dose insulin, and the treatment effect was compared between the two groups. Results The FBG and PBG in the group A were slightly lower than those in the group B, and the differences were not obvious(P>0.05), and the blood glucose standard-reaching time, ketone body negative time and PH recovery time in the group A were shorter than those in the group B, and the differences were obvious,(P<0.05), and the incidence rate of hypoglycemia in the group A was lower than that in the group B(P<0.05), after treatment, the biochemical indicators of the two groups were lower than those before treatment, and the differences were obvious(P<0.05). Conclusion The hypoglycemic effect of large-dose and small-dose insulin for DKA children is better, but the treatment safety of small-dose insulin is higher, with promotion value.
[Key words] Different doses; Insulin; Children with diabetic ketoacidosis
DKA是臨床兒科的高發(fā)病,其屬于急性代謝并發(fā)癥,發(fā)病機制為:在多種誘因下,糖尿病患兒出現(xiàn)胰島素迅速下降情況,使其血糖明顯升高,機體代謝功能嚴重紊亂,進而導(dǎo)致DKA[1]。其死亡率約為19%,需立即采取有效治療。胰島素注射是其常規(guī)療法,但使用劑量不同,療效也存有差異。研究中以2012年1月—2017年12月間入該院治療的24例DKA患兒為研究主體,旨在探究不同劑量胰島素治療DKA患兒的效果,現(xiàn)報道如下。
1 資料與方法
1.1 一般資料
以該院治療的24例DKA患兒為研究主體。經(jīng)倫理委員會直接審查,且得到批準。隨機分成A組和B組,各是12例。A組中,男7例,女5例;年齡范圍是3~11歲,平均(5.98±0.42)歲;隨機血糖為(24.22±0.13)mmol/L。B組中,男8例,女4例;年齡范圍是2~12歲,平均(5.19±0.33)歲;隨機血糖為(23.87±0.26)mmol/L。上述數(shù)據(jù)對比差異無統(tǒng)計學意義(P>0.05),可比較。
1.2 方法
所有患兒均進行常規(guī)治療,如補液擴容、抗感染和糾正水電解質(zhì)失衡等。A組給予小劑量胰島素(國藥準字H11020548)治療:劑量為0.05~0.10 U/(kg·h),行靜脈持續(xù)滴注治療,滴速為1 mL/(kg·h)。B組給……