重度颅脑损伤后血钠血糖变化与预后关系的临床研究  

The clinical study of the changes of blood glucose and natriun and prognosis of the serious cerebral injuries

作　　者：张建军[1] 董伟峰[1] 朱镇宇[1] 张俊[1] 

机构地区：[1]浙江省萧山市第一人民医院神经外科,311200

出　　处：《中国航天工业医药》2001年第3期19-21,共3页

摘　　要：目的探讨重度颅脑损伤者的血钠血糖变化特点及对预后的影响。方法对1997年1月～1999年12月312例重度颅脑损伤者的血钠血糖进行监测。将伤后24h、72h及1周后的血钠、血糖的变化进行对比分析 ,并对影响预后的高钠、高糖患者进行伤情特点分析。结果重度颅脑损伤后低钠发生率明显高于高钠(P<0.05) ,1周后出现高钠患者的死亡率明显高于未出现高钠者(P<0.01);血糖难以用药物控制的患者死亡率明显高于能够被控制者(P<0.01) ;若高钠合并高糖则预后更差。血钠变化及血糖升高的发生率24h与1周后无明显差异。结论重度颅脑损伤后钠代谢失衡及血糖升高与脑损伤本身病理机制有关 ;有效控制1周后高钠。Objective To evaluate the characteristics of the changes of blood glucose and natrium in the serious cerebral injuries and the prognosis of them. Methods To monitor the blood glucose and natrium in 312 cases with serious cerebral injury who were admitted in from Jan. 1997 to Dec.1999. The changes of blood glucose and natrium at 24 hour, 72 hour, 1 week were analysed, and the injury characteristic which interfered with the prognosis was also analysed. Results The rate of hyponatremia was higher than hypernatremia in serious cerebral injuries(P<0.05), the mortality was higher in the hypernatremia patients than in normal natrium patients(P<0.01) after 1 week, the mortality was higher in the patients whose hypernatremia could not be cured than those symptom could be cured; the prognosis would be worse if the hypernatremia accompanied with hyperglycosemia. The change of blood natrium and the rate of hyperglycosemia were no significant difference between at 24 hour and 1 week. Conclusion The natrium decompensation and hyperglycosemia of the serious cerebral injuries were related to the injury itself; the survive rate would be improved if the hypernatremia, hyperglycosemia or hypernatremia accompanied with hyperglycosemia could be controled.

关 键 词：重度颅脑损伤 钠代谢 高血糖 预后 

分 类 号：R651.15[医药卫生—外科学]