创伤患者急性期血糖含量与血压、血氧饱和度的对比研究  

Comparative study on blood glucose,blood pressure and blood oxygen saturation in early phase of trauma

作　　者：许太武[1,2] 丁玉兴[1,2] 李晓亮[1,2] 张步振 高明[1,2] 

机构地区：[1]昆明市成都军区昆明总医院 [2]昆明医学院第一附属医院

出　　处：《中国危重病急救医学》1996年第10期604-605,共2页Chinese Critical Care Medicine

摘　　要：探讨创伤患者急性期血糖（Ｇｌｕ）含量变化与动脉收缩压（ＳＢＰ）、血氧饱和度（ＳａＯ２）及预后的关系。测定３１例创伤患者术前的Ｇｌｕ含量，结合ＳＢＰ、ＳａＯ２进行对比研究。结果：创伤组术前Ｇｌｕ（８．１４±２．４７ｍｍｏｌ／Ｌ）与正常组（４．７２±１．３８ｍｍｏｌ／Ｌ）比较有极显著性差异（ｔ＝６．３７，Ｐ＜０．００１）；ＳＢＰ＜８．０ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）与＞８．０ｋＰａ组比较，Ｇｌｕ（１０．３２±２．３７ｍｍｏｌ／Ｌ比６．７４±１．３２ｍｍｏｌ／Ｌ）和ＳａＯ２（０．７４±０．３７比０．９１±０．１１）均有极显著性差异（Ｐ均＜０．００１），并且ＳＢＰ越低，Ｇｌｕ越高，ＳａＯ２呈直线下降；术前Ｇｌｕ与患者的预后也显著相关，死亡组术前Ｇｌｕ（１２．５３±１．７３ｍｍｏｌ／Ｌ）明显高于存活组（７．３５±１．５６ｍｍｏｌ／Ｌ），而ＳＢＰ（４．２９±４．１３ｋＰａ）、ＳａＯ２（０．２９±０．０６）则明显低于存活组（分别为１０．８６±１．７８ｋＰａ和０．８８±０．０８，Ｐ＜０．００１）。作者结合文献复习就创伤患者高血糖的发生机制。To study the relationship of blood glucose(Glu).with blood pressure,blood oxygen saturation (SaO 2)and the prognosis,the serum Glu,systolic blood pressure(SBP),SaO 2 were measured in 31 patients with trauma.The results showed that Glu was higher in patients with trauma (8 14±2 47mmol/L)than normal subjects(4 72±1 38mmol/L)( t =6 37, P <0 001).There was a significant difference in Glu and SaO 2 between the patients with SBP<8 and >8kPa,and the lower the SBP,the higher the Glu(10 32±2 37mmol/L vs 6 74±1 32mmol/L),with a linear decrease of SaO 2(0 74±0 37 vs 0 91±0 11)( P <0 001).In addition,the preoperative Glu was significantly related to the patients' prognoses.The Glu in the patients of the group of death (12 53±1 73mmol/L)was significantly higher than that of the survivors(7 35±1 56mmol/L),but SBP(4 29±4 13kPa) and SaO 2 (0 29±0 06)were significantly lower(in surviors,SBP 10 86±1 78kPa,SaO 2 0 88±0 08)( P <0 001).The mechanism of hyperglycemia and the influence of hyperglycemia on the prognosis,as well as the treatments were discussed.

关 键 词：创伤 血糖 血压 

分 类 号：R641[医药卫生—外科学]