本文選題：胰島素泵 + 胰島素皮下注射　； 參考：《重慶理工大學(xué)》2015年碩士論文

【摘要】：糖尿病(DM)是一種主要臨床表現(xiàn)為糖類代謝紊亂繼發(fā)蛋白質(zhì)和脂肪代謝紊亂的常見慢性病,其病理生理基礎(chǔ)是機(jī)體胰島素分泌相對或絕對不足、胰島素作用低下或者胰島素抵抗,由遺傳和環(huán)境因素共同作用。.隨著近年人民生活水平提高、生活方式的改變,其發(fā)病率和患病率呈逐年明顯上升趨勢,日益成為威脅人類健康的世界性公共衛(wèi)生問題。持續(xù)的高血糖及代謝紊亂狀態(tài)可導(dǎo)致全身組織臟器(尤眼、腎、心血管及神經(jīng)系統(tǒng))慢性損害,而嚴(yán)重代謝紊亂者亦可引起酮癥酸中毒和高滲昏迷等急性并發(fā)癥,使得人民生活質(zhì)量明顯下降的同時(shí)并威脅著我們的生命。糖尿病是一個(gè)需要終身控制的疾患,有效預(yù)防及控制糖尿病及糖尿病并發(fā)癥發(fā)生發(fā)展,具有極其重要意義。目前治療糖尿病的綜合治療手段主要包括降糖、降壓、調(diào)脂、抗凝、控制體重、改善生活方式等,其中降糖任務(wù)貫穿糖尿病患者生命始終�！敖堤恰辈粌H僅指將血糖降至正常,怎樣更好、更平穩(wěn)、更少副反應(yīng)、更多收益來維持正常血糖狀態(tài)顯得更至關(guān)重要。降糖藥物中胰島素具有降糖效果好、保護(hù)胰島功能的優(yōu)點(diǎn),是其他降糖藥物不能替代的。胰島素是胰島β細(xì)胞功能低下或缺陷的最佳選擇,包括1型糖尿病、部分胰島分泌障礙口服降糖藥物難以控制的2型糖尿病及合并某些特殊病情的血糖增高(如應(yīng)激性高血糖,妊娠糖尿病,兒童糖尿病,并發(fā)急性代謝紊亂的2型糖尿病,圍手術(shù)期的2型糖尿病,合并肺結(jié)核等營養(yǎng)不良因素的2型糖尿病,合并腦卒中、心力衰竭、腎功能衰竭等嚴(yán)重疾患的2型糖尿病等)。與常規(guī)胰島素治療方案相比,強(qiáng)化胰島素治療方案能更好模擬人胰島素正常生理分泌模式,更有效預(yù)防糖尿病慢性并發(fā)癥發(fā)生發(fā)展。強(qiáng)化治療有兩種方式:胰島素泵治療(CSII)和每日多次胰島素注射(MSII)。其中近年對胰島素泵方式的重要性越來越受到關(guān)注。研究目的:對CSII與MSII在2型糖尿病強(qiáng)化降糖中療效差異進(jìn)行對比,尋求一種讓患者更受益的治療方式。研究方法:將60例2型糖尿病患者隨機(jī)分成兩組,CSII組采用諾和靈#174;R胰島素泵治療,MSII組采用三餐前諾和靈#174;R和睡前諾和靈#174;N治療。監(jiān)測兩組病人治療前后全天血糖譜的變化,比較血糖達(dá)標(biāo)所需要的時(shí)間、胰島素用量和低血糖發(fā)生率等情況。研究結(jié)果:CSII組與MSII組相比,在血糖達(dá)標(biāo)所需的時(shí)間、胰島素用量及低血糖發(fā)生率等方面具有顯著性差異(P0.05)。研究結(jié)論:CSII和MSII均能有效治療2型糖尿病。其中,CSII能更好模擬生理性胰島素分泌模式,控制血糖效果更好,達(dá)標(biāo)時(shí)間短,胰島素用量小,低血糖發(fā)生率低。CSII明顯優(yōu)于MSII,值得臨床應(yīng)用推廣。
[Abstract]:Diabetes mellitus (DMN) is a common chronic disease with main clinical manifestations of protein and fat metabolism disorder secondary to glucose metabolism disorder. Its pathophysiological basis is relative or absolute insufficiency of insulin secretion, low insulin function or insulin resistance. By genetic and environmental factors. With the improvement of people's living standard and the change of life style in recent years, the incidence and prevalence rate of the disease have been increasing year by year, which has become a worldwide public health problem threatening human health. Persistent hyperglycemia and metabolic disorders can lead to chronic damage to systemic organs (especially eyes, kidneys, cardiovascular and nervous systems), while severe metabolic disorders can lead to acute complications such as ketoacidosis and hyperosmotic coma. So that the quality of life of the people at the same time a significant decline and threaten our lives. Diabetes mellitus is a disease that needs lifelong control. It is of great significance to prevent and control the occurrence and development of diabetes mellitus and its complications. At present, the comprehensive treatment of diabetes mainly includes reducing sugar, lowering blood pressure, regulating lipid, anticoagulant, controlling body weight, improving life style and so on. "hypoglycemia" is not just about lowering blood sugar to normal. It's even more important to be better, smoother, less side effects, and more revenue to maintain normal blood sugar. Insulin has good hypoglycemic effect in hypoglycemic drugs and can not be replaced by other hypoglycemic drugs because of its advantages of protecting islet function. Insulin is the best choice for islet 尾 cell dysfunction or deficiency, including type 1 diabetes, type 2 diabetes, which is difficult to control by oral hypoglycemic drugs, and hyperglycemia associated with specific conditions, such as stress hyperglycemia. Gestational diabetes, childhood diabetes, type 2 diabetes complicated with acute metabolic disorder, type 2 diabetes during perioperative period, type 2 diabetes with malnutrition such as tuberculosis, stroke, heart failure, Type 2 diabetes mellitus with severe renal failure and other diseases. Compared with conventional insulin therapy, intensive insulin therapy can better mimic the normal physiological secretion pattern of human insulin and prevent the development of diabetic chronic complications. Intensive therapy comes in two ways: insulin pump therapy (CSII) and multiple daily insulin injections (MS II). In recent years, more and more attention has been paid to the importance of insulin pump. Objective: to compare the efficacy of CSII and MSII in intensive hypoglycemia in type 2 diabetes mellitus. Methods: 60 patients with type 2 diabetes mellitus were randomly divided into two groups: CSII group treated with Novolin #174R insulin pump and MSII group treated with three-prandial Novolin #174R and bedtime Noir and #174N. The changes of blood glucose spectrum before and after treatment were monitored, and the time required for blood glucose to reach the standard, the amount of insulin and the incidence of hypoglycemia were compared between the two groups. Results compared with MSII group, there were significant differences in the time required for blood glucose standard, the amount of insulin and the incidence of hypoglycemia in the two groups (P 0.05). Conclusion both MSII and VCSII are effective in the treatment of type 2 diabetes. CSII can better simulate physiological insulin secretion model, control blood glucose effect better, meet the standard time is short, insulin dosage is small, low incidence of hypoglycemia. CSII is obviously superior to MSII.CSII is worthy of clinical application.
【學(xué)位授予單位】：重慶理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1

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相關(guān)期刊論文 前1條

1 何麗;郭盛;李嬪;陳臨琪;;常規(guī)注射胰島素和胰島素泵治療的1型糖尿病兒童主觀生活質(zhì)量及影響因素研究[J];臨床兒科雜志;2008年09期

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本文編號：1843776