严重脑外伤急性期血糖变化的临床意义  

Clinical Significance of Admission Hyperglycemia in Patients with Severe Head Injury

作　　者：张赛 杨树源 王明璐 杨卫东 杨学军 高之宪 孙伟 崔健忠 

出　　处：《中华创伤杂志》1994年第1期2-4,共3页Chinese Journal of Trauma

摘　　要：作者测定了５９例成人严重脑外伤（ＧＣＳ≤８分）入院时（≤６小时）血糖含量，结合临床病情及预后进行对比研究，结果表明：脑外伤组血糖水平显著高于正常值（Ｐ＜０．０５）；入院时血糖水平与ＧＣＳ显著相关（Ｐ＜０．００１）；ＧＣＳ３～４分、５～６分、７～８分三组入院时的血糖含量分别平均为１２．３２±３．１５、９．０８±２．９８、６．２４±１．０７（ｍｍｏｌ／Ｌ）。入院时血糖水平与病人的预后亦显著相关（Ｐ＜０．００１）；伤后１月内恢复良好、差、死亡三组病人入院时血糖含量分别平均为６．１１±１．０１、８．３９±１．７９、１２．３６±３．３４（ｍｍｏｌ／Ｌ）。入院时血糖含量≥１０ｍｍｏｌ／Ｌ者，死亡率明显增高（Ｐ＜０．００１）。结合文献，讨论了严重脑外伤急性期高血糖反应的发生机理，对预后的影响及处理等问题。The admission serum glucose level was measured in 59 adult patients with severe head injury (GCS≤8) within 6 hours after injury. The results showed that (1) The admission serum glucose level was significantly higher in the patients than normal value ( P< 0.05);(2) The lower the GCS score was, the higher the serum glucose level was ( P< 0.001). The patients with GCS of 3～4, 5～6,7～8 had mean admission serum glucose levels of 12.32±3.15, 9.08±2.98, 6.24±1.07 (mmol/L) respectively; (3) The admission serum glucose level was correlated with GCS of these patient ( P< 0.001), the patients in the 3 groups of the dead, poor recovery and good recovery in the first month after injury had mean admission serum glucose levels of 12.36±3.34, 8.39±1.79, 6.11±1.01 (mmol/L) respectively; (4) The patients with admission serum glucose level≥10 mmol/L had significantly higher death rate during the first month postinjury ( P< 0.001). These data suggests that admission hyperglycemia is a frequent component of the stress response to severe head injury, a significant indicator of severity, and a significant predictor of outcome for severe head injury.

关 键 词：脑外伤 血糖 急性病 

分 类 号：R651.15[医药卫生—外科学]