严重创伤并急性呼吸衰竭患者血糖水平变化与极化液临床干预效果  

Change of blood gincose level and the clinical effect of the GIK on the patients with severe trauma combined with acute respiratory failure

作　　者：陈自力[1] 王占科[1] 黄强[1] 李剑[1] 罗建梅[1] 

机构地区：[1]解放军第九四医院急诊中心,江西南昌330002

出　　处：《中国急救医学》2006年第11期822-824,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨创伤合并急性呼吸衰竭患者血糖水平变化与极化液临床干预效果。方法本院创伤ICU病房收治的严重创伤合并急性呼吸衰竭患者381例,随机分为极化液组(195例)和基础对照组(186例)。观察极化液组患者血糖水平,并根据血糖水平、体质量以及输注的葡萄糖量,以本院提出的个体化极化液配方经验公式为指导,进行极化液临床干预,基础时照组除不进行极化液干预外其他治疗同极化液组。观察极化液组和对照组MODS发生率、感染率以及死亡率变化。结果极化液组MODS 50例(25．64%),对照组MODS 74例(39．78%),极化液组MODS的发生率明显低于对照组(P＜0．01)。极化液组感染86例(44．10%),对照组感染120例(64．52%),极化液组感染率明显低于对照组(P＜0．01)。极化液组死亡12例(6．15%),对照组死亡30例(16．13%)。结论极化液个体化临床干预可作为创伤合并急性呼吸衰竭患者MODS的重要防治辅助措施,值得临床推广。Objective To explore the change of blood glucose＇s level and the clinical effect of glucose insulin kalium（GIK） on the patients with severe traumatic combined with acute respiratory failure（ARF）. Method 381 patients in ICU with severe trauma and ARF were randomly divided into GIK treatment group（ n = 195） and control group（ n = 186） . To observe blood glucose＇s level of GIK treatment group and to intervene with GIK according to the experimental formula of GIK supplied by our hospital. The same treatment was done in the control group except the GIK therapy. To observe the incidence of MODS, infection rate and mortality of the two groups. Results The incidences of MODS （25.64% ,50 cases）and infection rate（44.10% ,86 cases）in GIK therapy group were less than those（ 39.78% ,74 cases）and（64.52%, 120cases） in the control group. 12 cases died in the GIK therapy group, the mortality was 6.15 % ; 30 cases died in the control group, the mortality was 16.13 %. Conclusion Individual clinical treatment of GIK may be an important assistant method to prevent and treat MODS of the patients with trauma combined with ARF.

关 键 词：创伤 急性呼吸衰竭 多器官功能不全综合征 血糖 极化液 个体化干预 公式 

分 类 号：R563.8[医药卫生—呼吸系统] R641[医药卫生—内科学]