目的:探讨食管癌合并糖尿病患者术后肠内营养期间胰岛素的理想给药途径。方法:55例食管癌合并糖尿病患者术后肠内营养期间,根据胰岛素给药途径分为静脉微量泵、皮下注射两组,观察两组血糖达标时间、平均血糖标准差、平均胰岛素用量,并记录低血糖、肺感染、伤口感染、泌尿系感染及吻合口瘘等相关并发症的发生率。结果:静脉微量泵组与皮下注射组相比血糖达标时间短(P〈0.05)、平均血糖标准差小(P〈0.05)、胰岛素用量少(P〈0.05)、各种感染以及低血糖症等相关并发症发生率低(P〈0.05)。结论:采用静脉微量泵小剂量输注外源性胰岛素血糖控制快速、平稳,术后并发症发生率低,是食管癌合并糖尿病患者术后肠内营养期间控制血糖较为理想的给药途径。
Objective: To evaluate the better administration route of insulin for the diabetic patients after esophagectomy during the time of enteral nutritionc (EN). Methods: 55 cases of diabetic patients after esophagectomy were divided into 2 groups: one group received continuous insulin and saline input with microinfusion pump, the control group received insulin with subcutaneous injection.The compliance time of plasma glucose ,standard deviation of the average plasma glucose and the mean insulin dosage were observed, the incidence of hypoglycemia, infection of incisional wound, lung and urinary system, and anastomotic stoma were monitored. Results: The plasma glucose of the group received continuous insulin and saline input with mieroinfusion pump was better than that of the control group, and the incidence of hypoglycemia,infection and anastomotic stoma were lower. Conclusion:Continuous insulin and saline input with microinfusion pump is the better administration route of insulin for the diabetic patients after esophagectomy during the time of EN in controlling plasma glucose,declining the incidence of hypoglycemia, infection and anastomotic stoma.