刘延梅++贾玉琴++包道日娜++李恒斌++潘竞++韦思宇++王晓雪

DOI：10.16658/j.cnki.1672-4062.2017.12.007

[摘要] 目的 探讨老年糖尿病患者髋部骨折围手术期胰岛素的应用效果。方法 选取43例该院于2016年1月—2017年1月所收治的髋部骨折的老年糖尿病患者，依患者实际情况于围手术期给予相应胰岛素治疗，观察患者治疗前后各阶段血糖水平变化、手术效果及并发症的发生情况。 结果 43例患者均安全渡过围手术期，患者术前1 d血糖水平明显低于入院时，术后2 d血糖水平明显低于术前，出院时血糖水平明显低于入院时，差异有统计学意义（P<0.05）；6例术后发生并发症，并发症的发生率为13.95%。结论 针对老年糖尿病患者，于髋部骨折围手术期给予胰岛素可有效控制患者血糖水平，促进手术的顺利完成，帮助患者安全度过围手术期，降低术后并发症的发生，值得在临床当中进行推广应用。

[关键词] 糖尿病；髋部骨折；围手术期；胰岛素

[中图分类号] R687.3 [文献标识码] A [文章编号] 1672-4062（2017）06（b）-0007-02

Application of Insulin during the Preoperative Period of Senile Diabetes Patients with Hip Fracture

LIU Yan-mei， JIA Yu-qin， BAO Dao-ri-na， LI Heng-bin， PAN Jing， WEI Si-yu， WANG Xiao-xue

Second Affiliated Hospital of Inner Mongolia Medical University， Hohhot， Inner Mongolia， 010030 China

[Abstract] Objective To study the application effect of insulin during the preoperative period of senile diabetes patients with hip fracture. Methods 43 cases of senile patients with hip fracture admitted and treated in our hospital from January 2016 to January 2017 were selected and the patients were given the corresponding insulin treatment during the preoperative stage according to the practical conditions of patients， and the changes of blood glucose level in various stages， operative effect and occurrence of complications were observed before and after treatment. Results 43 cases underwent the preoperative stage safely， and blood glucose level at 1 d before operation was obviously lower than that at admission（P<0.05）， and 6 cases were with complications after operation， and the incidence rate of complications was 13.95%. Conclusion The insulin treatment of senile diabetes patients with hip fracture can effectively control the blood glucose level， promote the successful completion of operation， help patients undergo the preoperative stage safely and reduce the occurrence of postoperative complications， and it is worth promotion and application in clinic.

[Key words] Diabetes； Hip fracture； During the preoperative stage； Insulin

髋部骨折是一种临床常见的好发于老年人的骨折类型，其治疗通常采取手术方式。但同时伴糖尿病的老年髋部骨折患者因血糖较高，体内代谢紊乱，致手术风险大大提升，且术后也极易产生各类并发症[1]。因此，于围手术期严格控制患者血糖对于髋部骨折的老年糖尿病手術的成功完成具非常重要的现实意义。为探讨胰岛素在老年糖尿病患者髋部骨折围手术期的应用效果，该案2016年1月—2017年1月选取了43例该疾病患者为对象进行研究，现报道如下。

1 资料与方法

1.1 一般资料

选取43例该院于2016年1月—2017年1月所收治的髋部骨折的老年糖尿病患者，所有患者均为2型糖尿病患者，且与WHO所制定糖尿病相关诊断标准相符。术前行双下肢血管彩色多普勒超声检查未发现下肢深静脉血栓，肾功能基本正常。……