摘要
目的探讨胰岛素推注在重症脑出血患者中的应用效果。方法选取2018年3月至2021年12月南昌市第三医院收治的60例重症脑出血患者作为研究对象,采用随机数字表法将患者分为泵注组(30例)和推注组(30例),对照组采用持续静脉泵注,观察组采用静脉单次推注。比较两组患者血糖变异情况:平均血糖(Av)、血糖标准差(SD)、血糖变异系数(CV),神经功能预后情况,生存和昏迷情况:28 d生存率和格拉斯哥(GCS)评分以及低血糖发生率。结果两组患者治疗后24 h内血糖水平比较,差异无统计学意义(P>0.05),推注组治疗一段时间后血糖水平低于泵注组,差异有统计学意义(P<0.05);两组患者治疗前血糖变异情况比较,差异无统计学意义(P>0.05),两组患者治疗后Av水平比较,差异无统计学意义(P>0.05),推注组治疗后SD、CV低于泵注组,差异有统计学意义(P<0.05);推注组治疗后神经功能恢复良好人数多于泵注组,差异有统计学意义(P<0.05);两组患者28 d生存率比较,差异无统计学意义(P>0.05);两组患者治疗前与治疗后GCS评分比较,差异无统计学意义(P>0.05);推注组低血糖发生率低于泵注组,差异有统计学意义(P<0.05)。结论静脉单次推注可显著降低重症脑出血患者血糖水平、改善血糖变异情况和神经功能预后并且不会增加患者死亡、昏迷情况和低血糖发生情况,可用于临床推广。
Objective To investigate the application effect of insulin injection in patients with severe cerebral hemorrhage.Methods From March 2018 to December 2021,60 patients with severe cerebral hemorrhage who were admitted to The Third Hospital of Nanchang were selected as the research subjects.By random number table method,the patients were divided into pump injection group(30 cases)and bolus injection group(30 cases).In the control group,continuous intravenous pump injection was used,and in the observation group,a single intravenous bolus injection was adopted.The changes of blood glucose between the two groups such as average blood glucose(Av),blood glucose standard deviation(SD),coefficient of variation(CV),and neurological prognosis were compared in the two groups.With regards to the survival and coma,28 day survival rate and Glasgow coma score(GCS),and low incidence of blood glucose in the two groups were compared.Results There was no significant difference in blood glucose level within 24 h after treatment between the two groups(P>0.05).The blood glucose level of the bolus injection group was lower than that of the pump injection group after a period of treatment,and the difference was statistically significant(P<0.05).There was no significant difference in blood glucose variation between the two groups before treatment(P>0.05),and there was no significant difference in Av levels between the two groups after treatment(P>0.05).SD and CV in the bolus injection group were lower than those in the pump injection group after treatment,and the differences were statistically significant(P<0.05).The number of people with good neurological function recovery in the bolus injection group was more than that in the pump injection group,and the difference was statistically significant(P<0.05).There was no statistical difference in the 28-day survival rate between the two groups(P>0.05).There was no significant difference in GCS scores between the two groups before and after treatment(P>0.05).The incidence of hypoglycemia in the
作者
喻贵
万维维
吴莹
舒明
YU Gui;WAN Weiwei;WU Ying;SHU Ming(Department of Critical Care Medicine,the third Hospital of Nanchang,Jiangxi Province,Nanchang330009,China)
出处
《中国当代医药》
CAS
2022年第30期53-56,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202211543)。
关键词
重症脑出血
胰岛素
推注
血糖变异
神经功能预后
Severe cerebral hemorrhage
Insulin
Bolus
Blood glucose variability
Neurological prognosis
