关键词: 全胰腺切除术, 皮下持续输注胰岛素

Abstract: Objective To investigate the effectiveness and safety of subcutaneous infusion unremittingly of insulin in the glucose management of patients underwent total pancreatectomy and sum up the basal rate setting range. Methods We enrolled in 4 patients underwent total pancreatectomy (1 male, 3 females), 48-74 years old, treated with subcutaneous infusion unremittingly of insulin and set basal rate in accordance with six paragraph method after total pancreatectomy in Peking Union Medical College Hospital from January 2012 to January 2017, and summarized the average of the whole day glucose, the coefficient of variation of the whole day glucose and the daily dose of insulin. Results The median of average of the whole day glucose of patients was 8.70 mmol/L. The median of coefficient of variation of the whole day glucose of patients was 0.21. Patient 1 and Patient 4 had hypoglycemia at night or fasting during the use of artificial pancreas, no severe hypoglycemia was observed. The median of daily dose of insulin of patients was 0.27 IU/kg. The basal rate setting range was 0~4: 0~0.9X，4~9: 0~1.0X，9~12: 1.2~1.8X，12~17: 1.2~1.8X，17~21: 0.8~2.2X，21~24: 0~0.8X (X was average basal rate). The median of average based dosage during the day and the night was 0.48 IU/h and 0.21 IU/h, respectively. Conclusions Application of subcutaneous infusion unremittingly of insulin can significantly reduce glucose fluctuations and the amount of insulin throughout the day, the based dosage during the night should be set far less than the based dosage of full day in patients underwent total pancreatectomy.

Key words: total pancreatectomy, subcutaneous infusion unremittingly of insulin