有可植入的泵的连续 intraperitoneal 胰岛素注入的复杂并发症

查看全文 作　　者：Peter R van [1]Dijk;Susan JJ [2]Logtenberg;Klaas H [3]Groenier;Jan Willem [4]Haveman;Nanno [5]Kleefstra;Henk JG [6]Bilo

机构地区：[1]Diabetes Centre, Isala Clinics, Dokter van Heesweg 2, 8000 GK Zwolle, The Netherlands;[2]Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;[3]Department of General Practice, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;[4]Department of Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;[5]Langerhans Medical Research Group, Dokter van Heesweg 2, 8025 BT Zwolle, The Netherlands;[6]Isala Clinics, Department of Internal Medicine, Dokter Spanjaardweg 12, 8025 AB Zwolle, The Netherlands

出　　处：《World Journal of Diabetes》索引2012年第3卷第8期,共7页

摘　　要：AIM: To monitor the course of continuous intraperitoneal insulin infusion (CIPII) and to gain more insight into possible complications. METHODS: A retrospective, longitudinal observational cohort study in patients with type 1 diabetes mellitus (T1DM) was performed. Only patients with 'brittle' T1DM who started CIPII between January 1, 2000 and June 1, 2011, and were treated in the only centre inThe Netherlands providing CIPII treatment (Isala clinics, Zwolle) were eligible for inclusion. Outcomes were defined as operation-free period (OFP), rate and type of complications. Subanalyses were made between patients starting CIPII from 2000 to 2007 and from 2007 onwards in order to study possible changes over time in complications and/or OFP. The OFP was calculated as the time from initial implantation to the date of first documented re-operation. If patients had not experi- enced an operation, their data were recorded at the date of last follow up or death. Kaplan-Meier curves were constructed to visualize the OFP. A (two-sided) P value of less than 0.05 was considered statistically significant. RESULTS: Fifty-seven patients were treated with CIPII, although one patient was excluded from analyses because of self-induced complications. In the remaining 56 patients, 70 complications occurred during 283 patient years. Catheter occlusion (32.9%), pump dysfunction (17.1%), pain at the pump site (15.7%) and infections (10.0%) were the most frequent complications. This resulted in a median OFP of 4.5 years (95% confidence interval 4.1-4.8 years) without any difference between the time periods. Fifty re-operations were performed because of complications, one per 5.6 patient years, with a decrease in pump dysfunction (P = 0.04) and pump explantations (P = 0.02) after 2007. In total, 9 episodes of ketoacidosis occurred during follow up and there were 69 hospital re-admissions, with a median duration of 6 d. CIPII was ceased in five patients due to recurrent infections (n = 2), pain (n = 1), inadequate glycaemic control (n = 1) or by own choice (n = 1). No CIPII related mortality was reported. CONCLUSION: The OFP has been stable over the last decade. No CIPII related mortality was reported. A significant decrease in pump dysfunction and explantation was seen after 2007 compared to the period 2000-2007. CIPII remains a safe treatment modality for specific patient groups. 关键词：DIABETES MELLITUS type 1 INTRAPERITONEAL INSULIN INFUSION INSULIN INFUSION systems COMPLICATIONS Surgery

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有可植入的泵的连续 intraperitoneal 胰岛素注入的复杂并发症

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