强化胰岛素治疗策略对严重脓毒症患者预后的影响

强化胰岛素治疗策略对严重脓毒症患者预后的影响

叶振海;桂敬敏;尤雷明;张烜舜;卢杰

【期刊名称】《中国医药》 【年(卷),期】2011(006)010

【摘要】Objective To investigate the effect of intensive insulin therapy on severe sepsis. Methods In a prospective,randomized controlled study, adult patients who were considered to need intensive care for at least three days were enrolled. On admission, one hundred and forty-two severe sepsis patients with hyperglycemia were randomly dividided into intensive insulin therapy group ( maintenance of blood glucose at a level between 4.4 and 6.1 mmol/L) or conventional therapy group ( infusion tapered when the level of glucose at a level between 10.0 and 11.1 mmol/L). Mortality in the ICU, mortality in the hospital, days weaning from mechanical ventilation, days in the ICU and in the hospital, new kidney injury and new hepatic injury during intensive care were observed. Results The days in the ICU (12 ±3 days vs 15 ±4 days) ,in the hospital ( 19 ±6 days vs 24 ±7 days) and the days weaning from mechanical ventilation (10 ± 2 days vs 14 ± 3 days) in intensive insulin therapy group were significantly reduced than those in the conventional therapy group (P ＜ 0.01 ). The mortality in the ICU (22.5％ in the intensive insulin therapy group vs 42.3％ in the conventional therapy group, P ＜0.05 ) and in the hospital (36.6％ vs 54.9％, P ＜0.05 )