摘要
目的:探讨重型颅脑损伤(Traumatic brain injury,TBI)术后血糖及乳酸水平与预后的关系。方法:将84例TBI手术治疗后收入我科的患者,入组条件为入院时格拉斯哥昏迷指数评分(GCS)低于8分,既往无糖尿病史,术中未输注含糖液体,无其他部位严重损伤,无重要脏器疾患,住院时间大于一周的患者,于手术后0h、24h、48h分别抽取静脉血进行血糖测定,抽取动脉血进行乳酸测定,根据预后(出院时的预后情况)分为存活组和死亡组,然后分别比较不同时段及两组间血糖和乳酸水平与预后的关系。结果:84例TBI患者术后血糖和乳酸的平均水平均高于正常参考值(P<0.05)。术后0h、24h及48h的血糖水平与预后呈负相关(相关系数r值分别为-0.581、-0.443、-0.177,均P<0.05),乳酸水平与预后亦呈负相关(相关系数r值分别为-0.300、-0.364、-0.117,均P<0.05)。死亡组0h,24h的血糖及乳酸水平显著高于存活组(P<0.05)。结论:TBI术后特别是早期,血糖及血乳酸水平均有不同程度升高,两者与预后均具有一定的相关性。我们可以将其作为早期评估预后的指标之一。
Objective：To investigate the relationships between the levels of the blood glucose and lactic acid and prognosis in the traumatic brain injured patients after surgical treatment.Method：84patients suffering from traumatic brain injury were divided into survival group and death group.The selected patients were on the basis of Glasgow Coma Scale score（GCS） less than 8points and without history of diabetes,sugary liquid infusion,other parts of a serious of injury,significant organ disease.The patients were stay in hospital more thanone week.Venous blood and arterial blood samples were taken from all the patients at 0hours,24hours and 48hours after surgical treatment.Then we compare the levels of the glucose and lactic acid for different time.The relationships between the blood glucose,lactic acid and prognosis were analyzed.Result：The 84patients after surgical treatment who had suffered traumatic brain injury had higher average of the blood glucose and lactic acid than normal（P0.05）.The level of blood glucose after 0hour,24hours and 48hours was negatively related with prognosis（r1=0.581,r2=-0.443,r3=-0.177,P0.05）.The level of blood lactic acid was also negative to prognosis（r1=-0.300,r2=-0.364,r3=-0.117,P0.05）.The blood glucose and lactic acid at 0hour and 24hours were higher in the death group than the survival group（P0.05）.Conclusion：The average level of the blood glucose and lactic acid of the patients after surgical treatment who had suffered from traumatic brain injury,especially at the early stages,were obviously higher than normal.The levels of blood glucose and lactic acid after surgical treatment may be used as one of a simple clinical index for predicting the prognosis of the traumatic brain injury.
出处
《临床急诊杂志》
CAS
2012年第6期384-386,共3页
Journal of Clinical Emergency
关键词
重型颅脑损伤
血糖
乳酸
预后
traumatic brain injury
blood glucose
blood lactic acid
prognosis
