Marescaux J, Vix M, Mutter D, Jeandidier N, Boivin S, Pinget M
Service de Chirurgie digestive et endocrinienne, Les Hôpitaux Universitaires, Strasbourg.
Chirurgie. 1993;119(9):579-84; discussion 584-5.
Recent improvements in miniaturization of implantable pumps and the ability of their control by tele transmission allowed implantation of autonomous pumps which administer insulin into the peritoneal cavity. Fifty-six patients with diabetes mellitus underwent implantation of 66 pumps with a mean function life of 21.8 months per patient. No patient died to this day. Tolerance of implanted components was good. Morbidity was limited to local events, in this series 4 cutaneous erosions, two of them dictating final pump explantation. Dosages of mean global blood-sugar, pre- and post-prandial blood-sugar, and glycosylated hemoglobin were all lower versus dosages before implantation. Statistically significant difference was demonstrated regarding mean global blood-sugar. Frequency of sever hypoglycemia incidents (4 in our series) and of biological hypoglycemia (blood-sugar < 65 mg/100 ml) was decreased, representing major benefit of the technique. The patients well-being and quality of life were notably amended. Implantable insulin-pump may be offered as a treatment alternative to conventional insulin-therapy, especially in cases of diabetes which are difficult to balance and particularly in cases with frequent hypoglycemic malaise.
近年来,植入式泵的小型化取得进展,且具备通过远程传输进行控制的能力,这使得能够植入可自主向腹腔注射胰岛素的泵。56例糖尿病患者植入了66台泵,每位患者的平均使用期限为21.8个月。至今无患者死亡。植入部件的耐受性良好。发病率仅限于局部事件,在本系列中出现了4例皮肤糜烂,其中2例导致最终取出泵。平均血糖、餐前和餐后血糖以及糖化血红蛋白的剂量均低于植入前的剂量。平均血糖方面显示出统计学上的显著差异。严重低血糖事件(本系列中有4例)和生物性低血糖(血糖<65mg/100ml)的发生频率降低,这是该技术的主要益处。患者的幸福感和生活质量得到显著改善。植入式胰岛素泵可作为传统胰岛素治疗的替代疗法,尤其适用于难以平衡血糖的糖尿病患者,特别是那些频繁出现低血糖不适的患者。