涂　梅　林国才　黄　蓉▲

1.福建医科大学附属龙岩第一医院内分泌科，福建龙岩364000；2.福建医科大学附属龙岩第一医院眼科，福建龙岩364000

定量糖类饮食联合胰岛素泵治疗眼科围手术期糖尿病患者的优势探讨

涂梅1林国才2黄蓉1▲

1.福建医科大学附属龙岩第一医院内分泌科，福建龙岩364000；2.福建医科大学附属龙岩第一医院眼科，福建龙岩364000

目的探讨定量糖类饮食联合胰岛素泵治疗眼科围手术期2型糖尿病患者的优势。方法选择2015年1月～2016年3月我院收治的94例眼科围手术期糖尿病患者分为两组，治疗组（CSII组）予定量糖类饮食，并使用胰岛素泵持续皮下输注胰岛素；对照组（MDI组）采用一日多次皮下注射胰岛素；观察两组术前FPG、2 hPG、日胰岛素用量、术前等待时间、总住院日、低血糖发生率、术后并发症发生率及满意度等情况。结果CSII组术前等待时间、总住院日、胰岛素日用量均少于MDI组（P＜0.01），且术前FPG、2 hPG均优于MDI组（P＜0.05）；CSII组无低血糖事件的发生，MDI组有6例，差异有统计学意义（P＜0.05）；CSII组无术后并发症，MDI组5例出现术后并发症，差异有统计学意义（P＜0.05）；CSII组出院前对治疗的总体满意度明显高于MDI组（P＜0.05）。结论2型糖尿病患者眼科围手术期使用定量糖类饮食联合胰岛素泵可以快速降低血糖，缩短患者术前等待时间及总住院日，时效性高；患者的胰岛素注射量减少，低血糖事件及术后并发症少，安全性高，患者满意度高。

胰岛素泵；眼科；围手术期；糖尿病

［Abstract］Objective To explore the advantages of quantitative carbohydrate diet combined with insulin pump in treatment of type 2 diabetes mellitus patients in ophthalmologic perioperative.Methods From January 2015 to March 2016，94 cases of type 2 diabetic patients in the department of ophthalmonogy in our hospital，were randomly divided into CSII group and MDI group；CSII group was given a quantitative carbohydrate diet and treated with insulin pump for continuous subcutaneous insulin infusion（CSII）；while MDI group used multiple daily injection（MDI）of insulin.The levels of FPG，2 hPG，daily insulin dosage，preoperative waiting time，hospitalization days，the incidence of hypoglycemia and postoperative complications，also the degree of satisfaction were compared.Results Time of preoperative and hospitalization in CSII group was shorter than MDI group（P＜0.01）；daily insulin dosage was significantly reduced，and preoperative 2 hPG and FPG were better than MDI group（P＜0.05）.CSII group had no hypoglycemic event，while MDI group had 6 examples，the difference was statistically significant（P＜0.05）；CSII group didn't occurr postoperative complications，MDI group had 5 cases，the difference was statistically significant（P＜0.05）.The overall satisfaction before discharge in CSII group was significantly higher than that in MDI group（P＜0.05）.Conclusion Using quantitative carbohydrate diet combined with insulin pump for ophthalmologic perioperative patients with type 2 diabetes can reduce blood glucose quickly，shorten the waiting time for operation and total time of hospitalization days，with higher timeliness；and also decreas insulin dosage，lessen hypoglycemic events and postoperative complications，with higher security and higher patient satisfaction.

［Key words］Insulin pump；Ophthalmology；Perioperative；Diabetes mellitus

目前我国围手术期糖尿病患者的比例不断上升，眼科也不例外，糖尿病……