中华护理杂志 ›› 2023, Vol. 58 ›› Issue (10): 1172-1177.DOI: 10.3761/j.issn.0254-1769.2023.10.003

• 糖尿病护理专题 • 上一篇    下一篇

微量泵持续静脉输注胰岛素优化方案的应用

田凤美1,2(), 谭丽萍1,2(), 陆亚琼1,2, 黄慧1,2, 赵丽爽1,2   

  1. 215004 苏州市 苏州大学附属第二医院护理部(田凤美,谭丽萍,黄慧),心血管科(陆亚琼);苏州大学护理学院(赵丽爽)
  • 收稿日期:2022-06-13 出版日期:2023-05-20 发布日期:2023-05-30
  • 通讯作者: 谭丽萍,E-mail:tlping67@126.com
  • 作者简介:田凤美:女,硕士,副主任护师,主任助理,E-mail:524519880@qq.com
  • 基金资助:
    2021苏州市护理人才青苗计划项目(SHQM202106)

Application of the optimized scheme of continuous intravenous insulin infusion with micro-pump

TIAN Fengmei1,2(), TAN Liping1,2(), LU Yaqiong1,2, HUANG Hui1,2, ZHAO Lishuang1,2   

  • Received:2022-06-13 Online:2023-05-20 Published:2023-05-30

摘要:

目的 落实以波特兰草案为依据的微量泵持续静脉输注胰岛素优化方案,改善急性心肌梗死合并2型糖尿病患者行经皮冠状动脉介入术后血糖水平。 方法 2021年3月—2022年2月将122例急性心肌梗死合并2型糖尿病行经皮冠状动脉介入术患者随机分为试验组和对照组,试验组采取静脉微量泵持续输注胰岛素优化方案,对照组依据波特兰草案调控血糖。采用平均血糖值、血糖标准差、平均血糖波动幅度、餐后血糖波动幅度及葡萄糖目标范围内时间评价患者在住院期间的血糖控制水平。 结果 两组的平均血糖值、血糖标准差及平均血糖波动幅度均降低,差异均具有统计学意义(P<0.05),餐后血糖波动幅度差异无统计学意义(P=0.154);两组住院期间葡萄糖目标范围内时间比较,差异均具有统计学意义(P<0.05)。 结论 护士通过实施微量泵持续静脉输注胰岛素优化方案可减小患者血糖波动幅度,提高葡萄糖目标范围内时间。

关键词: 急性心肌梗死, 2型糖尿病, 波特兰草案, 胰岛素, 微量泵, 护理

Abstract:

Objective To optimize the scheme of continuous intravenous insulin infusion with micro-pump based on Portland protocol,to improve blood glucose level in patients with acute myocardial infarction complicated with type 2 diabetes mellitus after percutaneous coronary intervention. Methods 122 patients with acute myocardial infarction complicated with type 2 diabetes undergoing percutaneous coronary intervention were randomly divided into a control group and an experimental group from March 2021 to February 2022. The patients of the control group received measures according to Portland protocol,and patients of the experimental group received the optimized scheme based on Portland protocol. The mean blood glucose,standard deviation of blood glucose,mean amplitude of glycemic excursion,postprandial glucose excursion and time in ranges were used to evaluate effectiveness of the scheme during hospitalization. Results The average blood glucose,standard deviation of blood glucose,mean amplitude of glycemic excursion and time in ranges in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05). The postprandial glucose excursion in the 2 groups was not statistically significant(P=0.154). Conclusion The optimized scheme can improve blood glucose in patients with acute myocardial infarction complicated with type 2 diabetes after percutaneous coronary intervention,and significantly increase time in range.

Key words: Acute Myocardial Infarction, Type 2 Diabetes Mellitus, Portland Protocol, Insulin, Micro-Pump, Nursing Care