Nursing research on continuous intravenous insulin infusion via pump in emergency patients with hyperosmolar hyperglycemic state
胰岛素静脉持续泵入在急诊高渗性高血糖状态患者中的护理研究

摘要

目的 探讨胰岛素静脉持续泵入用于急诊高渗性高血糖状态（HHS）患者的护理效果，明确该干预方式对患者血糖控制效率、并发症发生率及住院时间的影响，方法 选取2024年1月—2024年12月我院急诊收治的100例HHS患者为研究对象，按随机数字表法分为实验组（50例）与对照组（50例）。对照组采用常规胰岛素静脉滴注+常规护理，实验组采用胰岛素静脉持续泵入+针对性护理（含泵体维护、血糖动态监测、并发症预防等）。比较两组患者血糖达标时间、治疗72h内低血糖发生率、住院时间及多器官功能障碍综合征（MODS）发生率。结果 实验组血糖达标时间为（12.3±2.5）h，显著短于对照组的（20.1±3.8）h（P＜0.05）；实验组治疗72h内低血糖发生率为4.0%（2/50），低于对照组的18.0%（9/50）（P＜0.05）；实验组MODS发生率为2.0%（1/50），低于对照组的12.0%（6/50）（P＜0.05）。结论 对急诊HHS患者采用胰岛素静脉持续泵入配合针对性护理，可加快血糖达标速度，降低低血糖及MODS发生率，缩短住院时间，临床应用价值显著。

Abstract

Objective To explore the nursing effect of continuous intravenous insulin infusion via pump in emergency patients with Hyperosmolar Hyperglycemic State (HHS), and to clarify the impact of this intervention on patients' blood glucose control efficiency, complication rate and length of hospital stay.
Methods A total of 100 HHS patients admitted to the emergency department of our hospital from January 2024 to December 2024 were selected as the research objects. They were divided into the experimental group (50 cases) and the control group (50 cases) by random number table method. The control group received conventional intravenous insulin infusion combined with routine nursing, while the experimental group received continuous intravenous insulin infusion via pump combined with targeted nursing (including pump maintenance, dynamic blood glucose monitoring, complication prevention, etc.). The time to reach target blood glucose, incidence of hypoglycemia within 72 hours of treatment, length of hospital stay and incidence of Multiple Organ Dysfunction Syndrome (MODS) were compared between the two groups.
Results The time to reach target blood glucose in the experimental group was (12.3±2.5) hours, which was significantly shorter than that in the control group [(20.1±3.8) hours] (P＜0.05); the incidence of hypoglycemia within 72 hours of treatment in the experimental group was 4.0% (2/50), which was lower than that in the control group [18.0% (9/50)] (P＜0.05); the incidence of MODS in the experimental group was 2.0% (1/50), which was lower than that in the control group [12.0% (6/50)] (P＜0.05).
Conclusion   The application of continuous intravenous insulin infusion via pump combined with targeted nursing in emergency HHS patients can accelerate the speed of reaching target blood glucose, reduce the incidence of hypoglycemia and MODS, and shorten the length of hospital stay, which has significant clinical application value.