颅脑损伤患者急性期血糖水平的临床意义  

Clinical Significance of Admission Hyperglycemia in Patients with Acute Head Injury

作　　者：游洋[1] 李耀华[1] 林友俊[1] 杨天明[1] 

机构地区：[1]南京铁道医学院附属医院神经外科

出　　处：《南京铁道医学院学报》1999年第1期39-41,共3页Journal of Nanjing Railway Medical College

摘　　要：目的：探讨颅脑损伤患者急性期血糖水平与格拉斯哥昏迷评分（ＧＣＳ）及格拉斯哥预后评分（ＧＯＳ）的相互关系，以及高血糖的防治对策。方法：所有病人均在入院６ｈ内取肘静脉血测血糖，依ＧＣＳ评分将６５例患者分为两组：Ⅰ组（ＧＣＳ＞８分）３９例，Ⅱ组（ＧＣＳ≤８分）２６例。按ＧＯＳ评分，在伤后１个月时将病人分为良好（包括恢复良好和中残）、差（包括重残和植物状态生存）、死亡组。结果：Ⅰ组血糖（６．２±１．１）ｍｍｏｌ·Ｌ１，Ⅱ组血糖（１０．３±３．０）ｍｍｏｌ·Ｌ１，两组间的血糖含量差异有显著意义（Ｐ＜０．０１）。预后良好组血糖为（６．３±２．０）ｍｍｏｌ·Ｌ１，差组血糖为（８．４±１．８）ｍｍｏｌ·Ｌ１，死亡组血糖为（１２．３±３．３）ｍｍｏｌ·Ｌ１。经多元线性回归分析，其结果是ＧＯＳ＝３．５２－０．３１×ＧＣＳ＋０．０６０×血糖，Ｐ＜０．０１。结论：入院时血糖浓度越高，病情越严重，预后越差。测定入院时血糖含量。Objective:The purpose of the investigation was to study the relationship between admission hyperglycemia and Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) in patients with acute head injury as well as the measure for its control.Methods:The levels of blood glucose were measured in all patients within 6h after admission.Sixty-five patients were divided into 2 groups according to the GCS.Group Ⅰ consisted of 39 cases,GCS>8;group Ⅱ consisted of 26 cases,GCS≤8.According to GOS,The patients were divided into 3 groups:good outcome,poor outcome and death.Result:There was a significant difference( P <0.01) between the levels of blood glucose in groups Ⅰ and Ⅱ, (6.2±1.1)mmol·L 1 ,( 10.3 ±3.0)mmol·L 1 ,respectively .The levels of blood glucose in good outcome,poor outcome and death groups were found to be (6.3±2.0)mmol·L 1 ,(8.4±1.8)mmol·L 1 and (12.3±3.3)mmol·L 1 ,respectively.An analysis by multivariate linear regression showed that GOS=3.52-0.31×GCS+0.60×GLU, P <0.01.Conclusion:The higher the admission glucose levels in blood are,The poorer the outcome is.It is of great value to measure the glucose levels in blood on admission for judging the severity and outcome of the patients with acute head injury.

关 键 词：血糖水平 患者 颅脑损伤 急性期 预后 入院 病人 COS 防治对策 恢复 

分 类 号：R651.15[医药卫生—外科学] R743[医药卫生—临床医学]