Martin A L, Martin M M
Acta Diabetol Lat. 1978 Jan-Apr;15(1-2):81-7. doi: 10.1007/BF02581010.
Thirty-two episodes of diabetic ketoacidosis in 30 children treated with conventional repeated s.c. injections of insulin every 4 h are compared with 18 episodes in 14 children treated with continuous i.v. insulin infusion. Fluid therapy, bicarbonate and potassium supplementation were essentially the same for both groups. Recovery as reflected in serum glucose, bicarbonate and the rate of rehydration, was smoother and more rapid in the children receiving continuous i.v. insulin, though the difference just failed to attain statistical significance in this small series of cases. There was, however, a marked difference in insulin administered (0.58 U/kg +/- 0.05 SEM in the children treated with continuous i.v. insulin infusion vs 2.54 +/- 0.27 SEM in the children treated with repeated s.c. injections). Hypoglycemia was noted in 11 and hypokalemia in 10 children on conventional insulin therapy given every 4 h s.c. In contrast, there was no hypoglycemia and only one case of hypokalemia with the i.v. insulin infusion.
30名儿童采用每4小时皮下重复注射胰岛素的传统方法治疗，共发生32次糖尿病酮症酸中毒；14名儿童采用静脉持续输注胰岛素治疗，共发生18次糖尿病酮症酸中毒。两组的液体疗法、碳酸氢盐补充和钾补充基本相同。接受静脉持续输注胰岛素的儿童，在血糖、碳酸氢盐和补液速度方面的恢复更平稳、更迅速，不过在这一小系列病例中，差异未达到统计学显著性。然而，胰岛素用量有显著差异（静脉持续输注胰岛素治疗的儿童为0.58 U/kg±0.05标准误，皮下重复注射胰岛素治疗的儿童为2.54±0.27标准误）。每4小时皮下注射传统胰岛素治疗的儿童中，11例出现低血糖，10例出现低钾血症。相比之下，静脉输注胰岛素时未出现低血糖，仅1例出现低钾血症。
