创伤患者早期应激血糖升高对继发感染影响研究  

Study for the effect on secondary infection for trauma patients with early stress hyperglycemia

作　　者：吴德全[1] 魏曾曾[1] 王娟[1] 

机构地区：[1]安徽医科大学第二附属医院急诊外科,安徽合肥230601

出　　处：《护士进修杂志》2014年第6期486-488,共3页Journal of Nurses Training

摘　　要：目的探讨创伤患者早期应激血糖升高对继发感染的影响。方法回顾性分析2010年10月～2013年9月急诊入住我科82例创伤患者的临床资料，根据患者入院2h内、2～24h与24～48h的应激血糖情况，评出相应分值，然后算出三者之和的总分值，根据总分值的大小确定应激血糖级别，分为I级、Ⅱ级、Ⅲ级、Ⅳ级。分析各级应激血糖与患者住院期间发生的继发感染和平均住院时间的关系。结果82例患者中，血糖分值I级七2例（26．8％）、Ⅱ级34例（41．5％）、Ⅲ级17例（20．7％）、Ⅳ级9例（11％），应激血糖级别为Ⅲ、Ⅳ级创伤患者发生继发感染的百分率明显高于I、Ⅱ级患者（57．7％VS10．7％，P〈0．01），平均住院时间显著延长（17．20dVS6．09d，P〈0．01）；I级与Ⅱ级血糖升高患者继发感染发生率差异无显著意义（P〉0．05）。结论创伤患者应激血糖升高是继发感染和住院时间延长的重要因素之一，对患者病情进展有不利的影响，应引起临床工作者高度重视。Objective To explore the effect on secondary infection for trauma patients with early stress hyperglycemia. Method Retrospective analysis was used to analyze the clinical data of 82 traumatic patients in our emergency department from October 2010 to September 2013. Marks was given and caculated according to the patients＇ blood glucose change in 2, 2-24 and 24~48 hours. Then confirm Ⅱ、Ⅲ、Ⅳ stress blood glucose levels according to the total marks, The relationship between he stress blood glucose change at all levels and the secondary infections in patients during hospitalization was analyzed. Result There were 22 cases （26.8 %） for I level, 34 cases（41.5 % ） for Ⅱ level, 17 cases（20.7 %） for Ⅲ level, 9 cases（11%） for IV level. The percentage of occurrence in secondary infection was significantly higher in the HI and IV levels than that of I and Ⅱlevers for trauma patients（57. 7% vs 10.7% ,P〈0.01）. The average length of hospital stay was also significantly extended （17.20 days vs 6.09 days,P d0.01）. There was no significant difference between Ⅰ and Ⅱ levers for the occurrence of the secondary infection （P〈0.05）. Conclusion One of the important factors for the secondary infection and prolonged hospitalization was the changes of traumatic stress blood glucose, which have adverse effect on patients＇ disease progression. Clinical nurse should pay more attention to their changes of traumatic stress blood glucose.

关 键 词：创伤 应激 血糖升高 感染 

分 类 号：R473[医药卫生—护理学] R64[医药卫生—临床医学]