宋茵 张晓义

[摘要] 目的 探讨土豆片外敷对胰岛素注射导致的皮下脂肪增生的效果。 方法 选取2015年12月～2016年11月南通大学附属医院符合纳入及排除标准的糖尿病患者80例，运用随机数字表法将患者分为外敷组和对照组。外敷组进行一般护理+健康课程+土豆片外敷，对照组进行一般护理+健康课程。干预结束后，比较两组间及组内干预前和干预后血糖、糖化血红蛋白的情况，观察土豆片外敷干预措施对皮下脂肪的疗效。 结果 最终共有78例完成本研究，其中外敷组38例，对照组40例。干预后，两组患者皮下脂肪增生的疗效观察比较，差异有统计学意义（P < 0.05）。两组患者疼痛及渗漏发生率比较，差异有统计学意义（P < 0.05）。两组患者空腹血糖及糖化血红蛋白同干预前比较，差异均有统计学意义（P < 0.05）。 结论 规范的健康教育是减少局部不良反应发生的重要保证，土豆片贴敷能有效治疗因胰岛素注射导致的皮下脂肪增生。

[关键词] 糖尿病;皮下脂肪增生;土豆片外敷

[中图分类号] R473.5          [文献标识码] A          [文章编号] 1673-7210（2019）01（c）-0171-04

[Abstract] Objective To observe the effect of potato chips on subcutaneous lipohypertrophy in patients with insulin injection. Methods From December 2015 to November 2016， 80 dzabetes mellitus patients who met the inclusion and exclusion criteria in the Affiliated Hospital of Nantong University were selected， and the patients were divided into the external application group and the control group by random number table. The external application group was treated with general nursing， health courses and external application of potato slices. The control group was given general nursing and health courses. The blood glucose and glycated hemoglobin were companed ketween the two groups be ore and after the intervention， and the effect of external application of potato chips on subcutaneous fat was observed. Results A total of 78 patients completed the study， including 38 patients in the external application group and 40 patients in the control group. After intervention， the efficacy of subcutaneous fat hyperplasia between the two groups was observed and compared， and the difference was statistically significant （P < 0.05）. There were significant differences in pain and leakage between the two groups （P < 0.05）. The difference in fasting blood glucose and HbA1c between the two groups before and after intervention were statistically significant （P < 0.05）. Conclusion Standard healthy education is an important guarantee to reduce the occurrence of local adverse reactions. Potato chips sticking can effectively treat the subcutaneous fat hyperplasia caused by insulin injection.

[Key words] Diabetes mellitus; Subcutaneous lipohypertrophy; External application of potato chips

隨着社会经济的发展，糖尿病（diabetes mellitus，DM）患者在大幅增加，消耗了大量医疗卫生资源，社会、家庭经济负担沉重[1]。国际糖尿病联盟（IDF）的最新数据显示，中国拥有近1.1亿糖尿病患者，且数量仍呈上升趋势，预计2040年我国糖尿病患者将达1.5亿[2]。目前，我国2型糖尿病患者中采用胰岛素治疗者超过1/3[3]，在胰岛素使用过程中，由于患者长期注射或者使用胰岛素埋植技术，会产生皮下脂肪增生[4]、皮下脂肪萎缩、水肿甚至过敏现象，这会给患者的治疗产生极大的负面影响[5]。国外对糖尿病患者胰岛素注射人群进行普查，增生人群达到了48.8%[6]。皮下脂肪增生可导致胰岛素吸收障碍，影响血糖及糖化血红蛋白水平，长期以往会导致糖尿病急、慢性并发症发生[7]。临床中发现土豆能减轻甘露醇外渗所致的组织损伤，促进组织炎症的吸收和水肿的消退，接种疫苗后红肿和硬结，用土豆片进行外敷不仅能积极消肿，而且能预防进一步的肿胀[8-9]。……