Zhong Zhifeng, Huang Huaying, Han Yuejun, Dong Wuzhen
Department of Colorectal and Anal Surgery, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China.
Department of Endocrinology and Metabolism, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China.
Exp Ther Med. 2019 Sep;18(3):1539-1544. doi: 10.3892/etm.2019.7773. Epub 2019 Jul 12.
Efficacy of insulin with different administrations for patients with diabetes complicated with perianal abscess and the effect on serum inflammatory cytokines were investigated. One hundred and sixty-seven patients with type 2 diabetes who underwent radical operation of perianal abscess in Jinhua Hospital of Zhejiang University from January 2014 to December 2016 were analyzed. Before and after the operation, 89 patients who received continuous intravenous pumping of insulin for blood glucose control were set as an observation group, and 78 patients who received intermittent subcutaneous injection of insulin as a control group. The operative efficacy, wound healing time and 1-week postoperative growth of the granulation tissue were scored and compared. Fasting blood glucose (FBG) and 2 h postprandial blood glucose (2hPBG) before and after treatment were recorded and compared. Fasting venous blood was extracted before and on the 3rd and 7th days after operation to detect and compare serum inflammatory cytokines including tumor necrosis factor (TNF-α) and interleukin-6 (IL-6). Patients in the observation group had significantly higher total effective rate of the operation than that in the control group (P<0.05), and significantly shorter wound healing time and significantly lower growth score of the granulation tissue (P<0.05). Before treatment, there was no significant difference between the two groups in FBG and 2hPBG (P>0.05). After treatment, FBG and 2hPBG were significantly lower than those before treatment (P<0.050), and FBG and 2hPBG after treatment in the observation group were significantly lower than those in the control group (P<0.05). In conclusion, insulin pumps for injection during the perioperative period of patients with diabetes complicated with perianal abscess can better control the patients' blood glucose, improve the operative efficacy and promote the patients' postoperative healing. Moreover, continuous intravenous pumping of insulin is significantly better than traditional intermittent subcutaneous injection of it in controlling inflammation, so it is worthy of application.
探讨不同给药方式的胰岛素对糖尿病合并肛周脓肿患者的疗效及对血清炎症细胞因子的影响。分析2014年1月至2016年12月在浙江大学金华医院行肛周脓肿根治术的167例2型糖尿病患者。将术后采用胰岛素持续静脉泵入控制血糖的89例患者设为观察组，将采用胰岛素间断皮下注射的78例患者设为对照组。对手术疗效、伤口愈合时间及术后1周肉芽组织生长情况进行评分并比较。记录并比较治疗前后的空腹血糖（FBG）和餐后2小时血糖（2hPBG）。于术前及术后第3天、第7天抽取空腹静脉血，检测并比较血清炎症细胞因子，包括肿瘤坏死因子（TNF-α）和白细胞介素-6（IL-6）。观察组患者手术总有效率显著高于对照组（P<0.05），伤口愈合时间显著缩短，肉芽组织生长评分显著降低（P<0.05）。治疗前，两组患者的FBG和2hPBG比较，差异无统计学意义（P>0.05）。治疗后，FBG和2hPBG均显著低于治疗前（P<0.05），且观察组治疗后的FBG和2hPBG显著低于对照组（P<0.05）。综上所述，糖尿病合并肛周脓肿患者围手术期采用胰岛素泵注射能更好地控制患者血糖，提高手术疗效，促进患者术后愈合。此外，胰岛素持续静脉泵入在控制炎症方面明显优于传统的胰岛素间断皮下注射，值得应用。
