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目的 探讨重组人生长激素 (rh GH)在手术后危重病人应用过程中出现的高血糖血症等并发症。方法 我科 2 0 0 3年 3月至 2 0 0 3年 6月 8例手术后危重病人应用重组人生长激素——思真 (Saizen) ,手术后第一天开始应用 ,剂量 8～ 1 0 U/ day,疗程 2周。所有病人均予以 TPN治疗 ,供应热量为 30 Kcal/ kg/ day,根据糖量予以相应的胰岛素。糖尿病病人根据术前胰岛素用量予以增加剂量。手术后一周内每天 4次监测静脉血糖 ,调整胰岛素用量。结果 8例病人有 6例出现用药后血糖升高 ,血糖升高的平均时间是第 2～ 3天 ,高峰期在第 7～ 1 0天。其中 2例出现严重的高血糖 ,经过增加胰岛素用量 ,血糖仍高达 35 mmol/ L ,不易控制。 2例病人并发严重的腹腔感染、 ARDS,抢救无效死亡。结论 危重病人手术后应用重组人生长激素可能造成难以控制的高血糖血症 ,应慎用或不用重组人生长激素
Objective To investigate the complications of recombinant human growth hormone (rh GH) in the application of critical postoperative patients such as hyperglycemia. Methods From March 2003 to June 2003, 8 cases of critically ill patients after operation were treated with recombinant human growth hormone (Saizen), and the application started on the first day after operation. The dosage ranged from 8 to 10 U / day, treatment for 2 weeks. All patients were treated with TPN, the supply of heat for 30 Kcal / kg / day, according to the amount of sugar to be the appropriate insulin. Diabetic patients according to preoperative insulin dosage to be increased dose. Intravenous blood glucose monitoring 4 times a day after surgery to adjust the amount of insulin. Results In 6 of 8 patients, the blood sugar increased after treatment. The mean time of blood sugar increase was from 2 to 3 days and the peak was from 7 to 10 days. Serious hyperglycemia occurred in 2 of them. After increasing insulin dosage, the blood glucose was still as high as 35 mmol / L, which was not easy to control. Two patients complicated with severe abdominal infection, ARDS, died of rescue invalid. Conclusion The application of recombinant human growth hormone in critically ill patients may cause uncontrollable hyperglycemia after the operation. Recombinant human growth hormone