·糖尿病胰岛素治疗·

　　【摘要】 目的 比较糖尿病患者择期手术围手术期胰岛素泵(CSII)或每日多次皮下注射胰岛素(MSII)的效用及花费。 方法 选取近2年外科、妇科择期手术的T2DM患者56例，随机采用CSII或MSII治疗，比较血糖控制、围术期感染及治疗费用。 结果 CSII、MSII两组治疗后血糖均较治疗前降低(P均<0.01)，两组间比较差异无统计学意义(P>0.05)。CSII组血糖达标时间、胰岛素总量均较MSII组低[(3.0 vs 4.0) d;(39.07±3.15)vs(44.27±4.33)U，P<0.05];CSII组术切口愈合时间、抗菌素使用天数及抗菌素使用费用较MSII组降低[(7.03±1.40)vs(8.10±1.63) d，(4.14±1.25)vs(5.26±1.75) d，(688 vs 908)元，P<0.05];住院天数缩短[(11.03±1.82)vs(14.91±2.47)d，P<0.05]，非手术费用差异无统计学意义。 结论 与MSII，CSII能更有效地控制围手术期患者的血糖，减少低血糖发生、围术期感染及住院费用。

　　【关键词】 胰岛素泵;多次胰岛素皮下注射;糖尿病，2型; 围手术期

Comparison between insulin pump or multiple subcutaneous insulin injection therapy on perioperative diabetes patients GAO Jing ，LOU Xi-en，ZHANG Li-ping，et al. Department of Endocrinology,The third affiliated Hospital of Beijing Univercity of Chinese Medicine,Beijing 100029,China

Corresponding author: ZHANG Li-ping, E-mail:leapy@126.com

　　【Abstract】 Objective To compare the efficacy and cost of insulin pump(CSII) and multiple daily subcutaneous injection of insulin(MSII) therapy on T2DM patients in the perioperative phase. Methods Fifty-six T2DM patients undergoing surgery in resent two years were randomized into CSII or MSII groups. Blood glucose level, incidence of hypoglycemia, incision healing status and costs were compared. Results After treatment, the levels of FBG and 2 hBG were significantly decreased[FBG (5.92±0.79)vs(6.21±0.87)，2 hBG(8.37±1.57)vs(9.14±1.38)，P<0.05 ]. The time for controlling blood glucose to the target levels, the amount of insulin usage and the hypoglycemia incidence were significantly decreased in MSII group[3.0 vs 4.0 d，(39.07±3.15)vs(44.27±4.33)U， 3.4% vs 22.2%，P<0.05 or P>0.05). The incidence of postoperative infection rate, the incision healing time ,the days of using antibiotics and cost of antibiotic use in CSII group significantly less than that of MSII group[3.4%vs18.5%，(7.03±1.40)vs(8.10±1.63) d，(4.14±1.25)vs(5.26±1.75) d，688元vs 908元，P>0.05或P<0.05),while the days of hospital stay were significantly shorten[(11.03±1.82)vs(14.91±2.47)，P<0.05], the costs were not increased(2821.48元vs 2667.04元，P>0.05). Conclusion CSII is superior to MSII therapy in its remarkable efficady and cost-benefits ratio.

　　【Key words】 Cost of insulin pump(CSII); Multiple daily subcutaneous injection of insulin(MSII); Diabetes mellitus， type 2; Perioperative