院前低血糖中胰高血糖素与葡萄糖的比较。

A comparison of glucagon and glucose in prehospital hypoglycaemia.

作者信息

Howell M A, Guly H R

机构信息

Accident and Emergency Department, Derriford Hospital, Plymouth.

出版信息

J Accid Emerg Med. 1997 Jan;14(1):30-2. doi: 10.1136/emj.14.1.30.

DOI:10.1136/emj.14.1.30

PMID:9023620

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1342840/

Abstract

OBJECTIVE

To compare intramuscular glucagon with intravenous glucose in the prehospital management of hypoglycaemia in adults.

METHODS

In the first part of the trial all UK ambulance services were asked how their personnel treat prehospital episodes of hypoglycaemia. In the second part, two protocols for treating prehospital hypoglycaemia were studied. In phase 1, intramuscular glucagon 1 mg was used. In phase 2, intravenous glucose 25 g was used; if intravenous access was not possible, intramuscular glucagon was given.

RESULTS

33 out of 43 respondent ambulance services (76.7%) only use glucagon for prehospital hypoglycaemia; the remaining services use glucose and glucagon. In the second part of the study the median duration from diagnosis to full orientation (Glasgow coma score 15) was 28 minutes (95% confidence interval 18 to 49 minutes) in phase 1 and 11 minutes (95% confidence interval 8 to 19 minutes) in phase 2. This difference is statistically significant (P < 0.005). On-scene times were not significantly different.

CONCLUSIONS

Intravenous glucose is the treatment of choice in prehospital hypoglycaemia but glucagon should also be available for intramuscular use when intravenous access is not possible.

摘要

目的

比较成人低血糖院前处理中肌肉注射胰高血糖素与静脉输注葡萄糖的效果。

方法

在试验的第一部分，询问了英国所有救护车服务机构其工作人员如何处理院前低血糖发作情况。在第二部分，研究了两种院前低血糖治疗方案。在第1阶段，使用1毫克肌肉注射胰高血糖素。在第2阶段，使用25克静脉输注葡萄糖；若无法建立静脉通路，则给予肌肉注射胰高血糖素。

结果

43个作出回应的救护车服务机构中，33个（76.7%）仅使用胰高血糖素处理院前低血糖；其余机构同时使用葡萄糖和胰高血糖素。在研究的第二部分，从诊断到完全清醒（格拉斯哥昏迷评分15分）的中位时长，第1阶段为28分钟（95%置信区间18至49分钟），第2阶段为11分钟（95%置信区间8至19分钟）。这一差异具有统计学意义（P < 0.005）。现场处理时间无显著差异。