發(fā)布時間：2018-09-08 20:07

【摘要】：目的比較無針注射與胰島素筆注射甘精胰島素血糖、胰島素用量及血糖波動有無差異,為糖尿病治療提供新的手段。方法選取治療方案為甘精胰島素+口服藥治療的糖尿病患者50名,按入院先后隨機分配A、B兩組,兩組分別25名患者,對所有入選患者進行糖尿病教育,使患者規(guī)范飲食及生活方式,并停止原治療方案,予人胰島素R+N強化治療3天。3天后A組使用胰島素筆注射甘精胰島素,B組使用無針注射器注射甘精胰島素;兩組患者連續(xù)監(jiān)測3天內(nèi)8段血糖(三餐前30分、餐后120分、晚22時、凌晨3時),并依據(jù)血糖調(diào)整胰島素劑量;比較無兩組患者空腹血糖變化、胰島素劑量變化、全天血糖波動。血糖波動通過計算標準差(SD)、平均血糖波動幅度(MAGE)來評價。MAGE計算方法:首先通過動態(tài)血糖監(jiān)測結(jié)果計算出患者24小時血糖標準差;然后計算每次血糖波峰與波谷之差為血糖波動幅度(AGE),無論血糖上升或下降支,當大于1個SD時認為是有效的AGE,并以第一個有效AGE方向為準;最后計算它們均數(shù)就是MAGE。結(jié)果1.無針注射甘精胰島素與胰島素筆注射相比較,使用無針注射器組空腹血糖低于使用胰島素筆組(P0.05);2.無針注射甘精胰島素與胰島素筆注射相比較,使用無針注射器組胰島素劑量少于使用胰島素筆(P0.05);3.無針注射甘精胰島素與胰島素筆注射相比較,兩者全天血糖波動無明顯差異(P0.05)。結(jié)論無針注射方式注射甘精胰島素與傳統(tǒng)注射方式比較,能有效降低空腹血糖且胰島素劑量減少,無針注射方式注射甘精胰島素具有良好的臨床療效。
[Abstract]:Objective to compare the difference of insulin glucose, insulin dosage and blood glucose fluctuation between needle free injection and insulin pen injection in order to provide a new method for the treatment of diabetes. Methods A total of 50 patients with diabetes treated with insulin glargine were randomly assigned to two groups according to their admission. 25 patients in the two groups were enrolled in diabetes education. After 3 days of intensive treatment of human insulin, group A used insulin pen to inject insulin glargine and group B used needle free syringe to inject insulin glargine. The patients in the two groups were monitored for 8 levels of blood glucose (30 minutes before three meals, 120 minutes after meal, 22:00 and 3 am) and adjusted insulin dosage according to blood glucose. Blood sugar fluctuates all day. Blood glucose fluctuation was evaluated by calculating standard deviation (SD), mean blood glucose fluctuation amplitude (MAGE). Mage calculation method: first, the 24-hour blood glucose standard deviation of patients was calculated by dynamic blood glucose monitoring results; Then the difference between the peak and trough of each blood glucose wave is calculated as the range of blood glucose fluctuation (AGE), whether the blood sugar rises or falls, the AGE, that is considered valid when more than 1 SD is considered valid and the first effective AGE direction is taken as the criterion; and the final calculation of their mean is MAGE.. Result 1. No needle injection of insulin glargine compared with insulin pen injection, the use of needle-free syringe group fasting blood glucose was lower than the use of insulin pen group (P0.05) 2. No needle injection of insulin glargine compared with insulin pen injection, the use of needle-free syringe group insulin dose is less than the use of insulin pen (P0.05) 3. There was no significant difference in blood glucose fluctuation between insulin injection and insulin pen injection without needle (P0.05). Conclusion compared with traditional injection, injection of insulin without needle injection can effectively reduce fasting blood glucose and decrease the dosage of insulin. Injection of insulin without needle injection has a good clinical effect.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1

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