ICU重症患者严重低血糖临床分析及对预后的影响  

The cfinic analysis of severe hypoglycemia in critically ill patients in intensive care unit and the effects on outcomes

作　　者：傅小云[1] 谌宏军[1] 苏德[1] 刘同华[1] 陈涛[1] 陈华军[1] 杨学忠[1] 陈森[1] 

机构地区：[1]遵义医学院附属医院重症医学科,贵州遵义563003

出　　处：《中国急救医学》2012年第8期689-691,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的分析ICU重症患者早期严重低血糖与延迟严重低血糖病情特点及对预后的影响。方法回顾性分析87例严重低血糖患者的病史资料，分为早期严重低血糖（入ICU24h发生的严重低血糖）及延迟严重低血糖（入ICU24h后发生的严重低血糖），分析两种严重低血糖患者的流行病学特点及对预后的影响。结果严重低血糖患者中，早期低血糖患者48例，延迟低血糖患者39例。ICU患者发生早期严重低血糖、延迟严重低血糖的发生率分别为10．12‰、8．38‰，差异无统计学意义（P〉0．05）；急诊入科的患者早期严重低血糖的发生率为1．95％，明显高于延迟低血糖的发生率为0．91％（P〈0．05），其他科室转入的患者早期低血糖、延迟低血糖发生率分别为5．20‰、7．80‰，差异无统计学意义（P〉0．05）；早期严重低血糖患者的死亡率及APACHEⅡ评分明显高于延迟严重低血糖患者（P〈0．05）。结论ICU患者出现严重低血糖提示病情危重，早期严重低血糖的死亡率明显高于延迟低血糖，应在临床引起重视。Objective To analyze retrospectively the clinic characters of the early severe hypoglycemia and delay severe hypoglycemia in critically ill patients in intensive care unit and their effects on outcomes. Methods To retrospectively analyze 87 cases with severe hypoglycemia from a series of 4712 patients and determine the the clinic characters of the early severe hypoglycemia （within 24 hours of ICU admission ） and delay severe hypoglycemia （outside 24 hours of ICU admission ） in critically ill patients in intensive care unit and their effects on outcomes. Results There were 48 cases with early severe hypoglycemia and 39 cases with delay severe hypoglycemia. The incidences of early severe hypoglycemia and delayed severe hypoglycemia were 10. 1‰ and 8.38‰ respectively （P 〉 0. 05 ）. The incidence of patients with early severe hypoglycemia from emergency department was higher than that of delayed severe hypoglycemia （ P 〈 0.05 ） ; the mortality and APACHE Ⅱ score in patients with early severe hypoglycemia were significantly higher than in patients with delayed severe hypoglycemia（ P 〈 0.05 ）. Conclusion Severe hypoglycemia in ICU patients is associated with patients in critical condition, The mortality in patients with early severe hypoglycemia were significantly higher than in patients with delayed severe hypoglycemia.

关 键 词：严重低血糖 重症监护病房(ICU) 预后 

分 类 号：R285.5[医药卫生—中药学]