摘要
目的探讨器官支持治疗干预对重症创伤患者感染的发生及血糖水平的影响。方法选取自2015年6月至2018年2月自贡市第四人民医院收治的153例重症创伤患者为研究对象。采用连续性静脉-静脉血液滤过(CVVH)联合主动脉球囊反搏(IABP)对患者进行干预,比较患者干预前后情况,并分析干预后感染发生风险与患者血糖水平的相关性。结果与器官支持治疗干预前比较,干预后重症创伤患者的心率显著降低,收缩压显著升高,尿量显著增加,脑钠肽显著降低,左室射血分数显著增加,血糖水平显著下降,谷丙转氨酶、总胆红素、白蛋白、血尿素氮、血肌酐、血尿素、血尿酸、尿肌酐、尿蛋白及血内生肌酐清除率异常的患者比例显著降低,差异均有统计学意义(P<0.05)。干预后,发生感染16例(10.5%)。根据干预后患者的血糖水平是否高于组内均值分为低血糖水平组(n=76)和高血糖水平组(n=77)。干预后,低血糖水平组感染3例(3.9%),高血糖水平组感染13例(16.9%),高血糖组感染发生率显著高于低血糖组,差异有统计学意义(P<0.05)。结论 CVVH联合IABP对控制感染的发生及改善患者的血糖水平具有一定的临床意义。
Objective To investigate the influence of organ support therapy on infection and blood glucose level in patients with severe trauma.Methods A retrospective study was performed on 153 cases of patients with severe trauma who were admitted from June 2015 to February 2018.Continuous veno-venous hemofiltration(CVVH) combined with intra-aortic balloon pump(IABP) was used to intervene the patients,and the situation before and after the intervention was compared,and the correlation between the risk of infection after the intervention and the blood glucose level of the patients was analyzed.Results Compared with before the organ support therapy intervention,intervention of severe trauma patients after heart rate reduced significantly,the marked increase in systolic blood pressure and urine volume increased significantly,brain natriuretic peptide significantly reduced,left ventricular ejection fraction increased significantly,their blood sugar levels dropped significantly,Alt,total bilirubin,albumin,blood urea nitrogen,serum creatinine,blood urea,blood uric acid,urine creatinine,urine protein and blood abnormal endogenous creatinine clearance ratio decreased significantly,the number of differences had statistical significance(P<0.05).After intervention,infection occurred in 16 cases(10.5%).Patients were divided into hypoglycemia group(n=76) and hyperglycemia group(n=77) according to whether their blood glucose level after intervention was higher than the intra-group mean.After the intervention,3 cases(3.9%) were infected in the hypoglycemic group,and 13 cases(16.9%) were infected in the hyperglycemic group.The infection rate in the hyperglycemic group was significantly higher than that in the hypoglycemic group,and the difference was statistically significant(P<0.05).Conclusion CVVH combined with IABP has certain clinical significance in controlling the occurrence of infection and improving the blood glucose level of patients.
作者
曾超
吴晓芳
ZENG Chao;WU Xiao-fang(Department of Emergency,the Fourth People's Hospital of Zigong City,Zigong 643000,China)
出处
《创伤与急危重病医学》
2019年第2期97-99,102,共4页
Trauma and Critical Care Medicine
关键词
器官支持干预
重症创伤
感染
血糖
Organ support intervention
Severe trauma
Infection
Blood glucose
