急性颅脑创伤早期血糖升高对预后的影响  

Effect of early stage hyperglycemia on prognosis in patients with acute craniocerebral injury

作　　者：栗浩[1] 陈永波[1] 王庆生[1] 

机构地区：[1]山东省新汶矿业集团华丰矿医院外科,山东泰安271413

出　　处：《中国现代医学杂志》2010年第19期2975-2977,共3页China Journal of Modern Medicine

摘　　要：目的探讨急性颅脑外伤后高血糖对预后的影响。方法对57例既往无糖尿病病史、无严重颅外合并症的颅脑损伤患者48h内的血糖变化进行检测,探讨伤后血糖水平与患者伤情、预后的关系。结果轻度(GCS13～15分)、中度(GCS9～12分)、重度(GCS3～8分)颅脑损伤患者出现不同程度的高血糖,平均血糖随着GCS降低,血糖依次升高。中度颅脑损伤患者的平均血糖水平高于轻度患者,重度颅脑损伤患者的平均血糖水平高于中度和轻度,差异均有显著性(P<0.05)。血糖>11.1mmol/L颅脑损伤患者的死亡率明显高于血糖<11.1mmol/L者死亡率,差异有显著性(P<0.05)。死亡患者的血糖水平明显高于存活患者血糖水平,差异有显著性(P<0.05)。结论颅脑创伤后早期出现的应激性高血糖可反映伤情的严重程度,可作为早期预测预后的简易指标。【Objective】To investigate the effect of hyperglycemia on prognosis in patients with acute craniocerebral injury.【Methods】The level of blood glucose was monitored in 57 cases of craniocerebral injury who had no history of diabetes or important extracranial complications.The relationship between the level of blood glucose and the degrees of injury as well as the prognosis was analyzed.【Results】Patients with mild（GCS 13～15）,moderate（GCS 9～12） or severe（GCS 3～8） traumatic brain injury showed hyperglycemia at different level,and the level of blood glucose was consistent with the degree of injury.The average blood glucose level of patients with moderate traumatic brain injury was significantly higher than that of patients with mild traumatic brain injury（P〈0.05）.The average blood glucose level of patients with severe traumatic brain injury was significantly higher than that of patients with mild or moderate traumatic brain injury（P〈0.05）.The death rate of patients with blood glucose11.1 mmol/L was significantly higher than that of patients with blood glucose11.1 mmol/L（P〈0.05）.The blood glucose level of non-survivors was significantly higher than that of survivors（P〈0.05）.【Conclusion】Hyperglycemia reflects the severity of traumatic brain injury,which can be used as an early and simple indicator of prognosis.

关 键 词：颅脑创伤 血糖 监测 预后 

分 类 号：R651.15[医药卫生—外科学]