# AI建议将胰岛素泵输注部位使用7天以节省耗材，忽略脂肪营养不良和吸收失败风险

- **ID:** `medical/insulin-pump-site-rotation-ignored`
- **领域:** medical
- **类别:** runtime_error
- **错误码:** `INSULIN-PUMP-005`
- **验证级别:** ai_generated
- **修复率:** 87%

## 根因

胰岛素泵输注装置必须每2-3天更换一次（根据制造商和ADA指南），以防止注射部位脂肪营养不良（肥大或萎缩），这会导致胰岛素吸收不可预测、高血糖和DKA风险；延长至7天会显著增加这些并发症。

## 解决方案

1. ```
   Follow the '3-2-1 rule': change infusion set every 3 days (72 hours maximum), rotate site to a different body quadrant each time, and ensure at least 2 cm distance from previous site. Use a site rotation log (paper or app like 'Pump Site Tracker'). Set a calendar reminder for 3-day intervals.
   ```
2. ```
   If supplies are limited, extend to 4 days maximum ONLY if using a steel cannula (e.g., Medtronic Sure-T) and monitoring blood glucose every 2 hours. Check site for redness, swelling, or pain. If glucose rises >50 mg/dL above baseline, change immediately.
   ```
3. ```
   Use a 'site assessment' protocol before each insulin bolus: inspect site for signs of lipodystrophy (hard lump, dimpling, or discoloration). Palpate for induration. If any abnormality found, change to a new site in a different region. Document site condition in pump log.
   ```

## 无效尝试

- **Rotate within the same general area (e.g., abdomen) every 7 days to minimize scar tissue** — Rotating within the same area still allows lipodystrophy to develop; sites should be at least 2 cm apart and in different body regions (abdomen, thigh, arm, hip) in rotation. (80% 失败率)
- **Use a longer cannula (e.g., 9mm instead of 6mm) to bypass surface lipodystrophy** — Longer cannula may reach deeper tissue but does not prevent subcutaneous lipodystrophy at the insertion point; absorption remains erratic. (75% 失败率)
- **Clean site with alcohol daily to prevent infection, allowing extended wear** — Daily cleaning does not prevent lipodystrophy or absorption failure; infection risk is secondary to tissue damage from prolonged cannula presence. (70% 失败率)