强化胰岛素治疗对重型颅脑外伤患者预后的影响  

Effect of intensive insulin therapy on prognosis of patients with severe traumatic brain injury

作　　者：姚宏伟[1] 

机构地区：[1]商丘市第一人民医院神经外科,河南省商丘476100

出　　处：《中国基层医药》2014年第6期866-867,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨强化胰岛素治疗对重型颅脑外伤患者预后的影响.方法 将130例重型颅脑外伤患者按数字表法随机分为观察组65例和对照组65例,分别接受强化胰岛素治疗和传统的胰岛素治疗,观察两组感染率、住院时间、病死率及随访6个月的总体病死率等指标.结果 观察组感染率（32.4％）明显低于对照组（46.7％）（x2=1.946,P＜0.05）,观察组的住院时间[（23.7±2.4）d]明显短于对照组[（36.3±2.9）d]（t =9.247,P＜0.05）;观察组院内病死率、随访6个月的总体病死率分别为27.6％、56.8％,对照组分别为26.8％、55.2％,两组差异均无统计学意义（x2=0.086、0.484,均P＞0.05）;随访6个月,观察组格拉斯哥评分4～5分（37.2％）明显高于对照组（19.8％）（x2=6.407,P＜0.05）.结论 强化胰岛素治疗能有效改善重型颅脑外伤患者预后.Objective To investigate the effects of intensive insulin therapy on prognosis of patients with se- vere traumatic brain injury. Methods 130 patients with severe traumatic brain injury （ GCS score 3-8） were randomly divided into the observation group （65 cases） and the control group （65 cases）. The observation group received in- tensive insulin therapy, while the control group received conventional insulin therapy. The infection rate, hospital stay, in-hospital mortality and the 6-month mortality were observed. Results The infection rate of the observation group （32.4%） was significantly lower than that of the control group （46.7%） （~2 = 1. 946, P 〈 0.05 ）. The hospi- tal stay of the observation group was significantly shorter than that of the control group（ t = 9. 247 ,P 〈 0.05）. The in- hospital mortality and the 6-month mortality were similar in the two groups （ X2 = 0. 086,0. 484, all P 〉 0.05 ）. The neurologic outcome according to Glasgow Outcome Score（ GOS 4-5） at 6 months in the observation group was better than that in the control group （ X2 = 6. 407,P 〈 0.05 ）. Conclusion Intensive insulin therapy can improve the prog- nosis of patients with severe traumatic brain injury.

关 键 词：颅脑损伤 强化胰岛素 血糖 

分 类 号：R651.15[医药卫生—外科学]