Neff K, Donegan D, MacMahon J, O'Hanlon C, Keane N, Agha A, Thompson C, Smith D
Ir Med J. 2014 May;107(5):141-3.
PN is associated with significant hyperglycaemia, which may be detrimental to clinical outcome. There are few data on the management of this phenomenon outside of intensive care units. In our unit, we studied the efficacy of protocol-based intravenous insulin delivery as compared to subcutaneous insulin prescribed individually outside of the critical care setting. In a retrospective review over a two-year period, we compared patients with PN-associated hyperglycaemia who had received both modes of insulin therapy. A total of 122 who developed PN-associated hyperglycaemia were identified. Those on the intravenous insulin regimen were within glycaemic target for more time than those on the subcutaneous regimen (62% Vs 43%, p = 0.008). We therefore conclude that outside of the critical care setting, intravenous insulin delivers better glycaemic control and should therefore be considered optimum therapy for patients with PN-associated hyperglycaemia.
肠外营养（PN）与显著的高血糖相关，这可能对临床结局有害。在重症监护病房之外，关于这种现象的管理的数据很少。在我们科室，我们研究了基于方案的静脉胰岛素输注与在重症监护环境之外单独开具的皮下胰岛素相比的疗效。在一项为期两年的回顾性研究中，我们比较了接受两种胰岛素治疗方式的PN相关高血糖患者。总共确定了122例发生PN相关高血糖的患者。接受静脉胰岛素治疗方案的患者血糖达标时间比接受皮下治疗方案的患者更长（62%对43%，p = 0.008）。因此，我们得出结论，在重症监护环境之外，静脉胰岛素能更好地控制血糖，因此应被视为PN相关高血糖患者的最佳治疗方法。
