摘要
目的了解高血糖与颅脑损伤严重程度之间的关系以及控制血糖对颅脑损伤预后的影响。方法我们前瞻性地研究了146例中重型颅脑损伤患者（格拉斯哥昏迷评分GCS3～12分）的血糖，并将血糖高于11．1mmol／L的患者随机分为两组，一组接受强化胰岛素治疗，将血糖控制在6．11mmol／L以下，另一组不接受胰岛治疗，以明确血糖水平同损伤严重程度之间的关系以及控制血糖对预后的影响。结果重型颅脑损伤患者的血糖水平明显高于中型颅脑损伤患者，并且颅内压水平同血糖水平显著相关。同血糖水平高于11．1mmol／L的患者相比，血糖控制在6．11mmol／L以下的患者预后明显改善。结论早期高血糖是颅脑损伤后应激反应的一个组成部分，是预测损伤严重度的一个重要指标，控制血糖可改善颅脑损伤患者的预后。
Objective To examine the relationship between hyperglycemia and the severity of head injury and to examine the influence of controlling serum glucose levels on outcome after head injury. Methods We prospectively studied serum glucose of 146 patients with moderate or severe craniocerebral injury （Glasgoe Coma Scale scores 3 - 12） to determine the relationship between serum glucose levels and severity of injury. Patients whose glucose levels greater than 200 - mg/dl were randomly assigned either to insulin treatment team （glucose levels were controlled under 110 mg/dl） or without insulin treatment team to determine the influence of controlling serum glucose levels on outcome after head injury. Result Patients with severe head injury had significantly higher serum glucose levels than did those with moderate injury. A significant correlation was found between the maximum intracranial pressure（ICP） level and the glucose value. Patients whose glucose level were controlled under 110 mg/dl had an favorable outcome compared with those glucose level greater than 200 mg/dl. Conclusion Early hyperglycemia is a frequent component of the stress response to head injury, a significant indicator of its severity, and a reliable predictor of outcome. Controlling serum glucose can improve outcome of craniocerebrat injury.
出处
《临床外科杂志》
2006年第8期495-497,共3页
Journal of Clinical Surgery
关键词
颅脑损伤
高血糖
神经系统预后
损伤严重度
head injury
hyperglycemia
neurological outcome
severity of injury
