颅脑外伤急性期血糖、肌酐的变化与疾病转归的研究  

Analysis on Blood Glucose,Creatinine Changes and Outcomes of Craniocerebral Trauma

作　　者：李慧[1] 蔡忠林[1] 梁仲珍 马莉[1] 徐倩[1] 孙建军[2] 周杰[2] LI Hui CAI Zhong-lin LIANG Zhong-zhen MA Li XU Qian SUN J ian-jun ZHOU J ie(Second Clinical Medical College, Lanzhou University, Lanzhou Gansu 730030, Chin)

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]兰州军区兰州总医院神经外科

出　　处：《华南国防医学杂志》2017年第5期297-299,304,共4页Military Medical Journal of South China

基　　金：国家自然科学基金项目(81372177)

摘　　要：目的探讨颅脑外伤患者伤后血糖、血肌酐水平与病情转归之间的关系。方法回顾性分析作者医院2014-10/2015-10月收治的71例颅脑外伤患者,根据格拉斯哥昏迷量表(Glasgow coma scale,GCS)分为轻、中、重3组,伤后1、3、7、14、30 d进行血糖及血肌酐水平测定并结合格拉斯哥结局量表(Glasgow outcome scale,GOS)评定分析1年后患者疾病转归情况。结果 3组患者伤后1 d血糖水平均升高,且重度GCS组血糖水平显著高于轻度及中度GCS组(P<0.05),此后3组患者血糖水平逐渐下降。3组患者伤后1、3、7 d血肌酐水平逐渐上升,14、30 d逐渐下降,其中重度GCS组于伤后3、7 d血肌酐水平明显高于轻度及中度GCS组(P<0.05)。患者预后转归情况重度GCS组中死亡2例、重度残疾4例、中度残疾1例、恢复良好1例;中度GCS组重度残疾2例、中度残疾36例、恢复良好2例;轻度GCS组中度残疾3例、恢复良好20例。结论颅脑外伤后血糖、血肌酐水平与GCS评分有着明显的关系,血糖、血肌酐水平越高,GCS评分越低,患者病情越严重,同时GCS评分越低患者转归越差。Objective To investigate changes of blood glucose, serum creatinine levels and outcomes of craniocere- bral trauma patients. Methods Seventy-one craniocerebral trauma patients from October 2014 to October 2015 were retrospectively analyzed and divided into mild, moderate and severe group according to Glasgow coma scale （GCS）. The blood glucose and serum creatinine levels were determined on 1st, 3rd, 7th, 14th and 30th day, and outcomes after 1 year were evaluated by Glasgow outcome scale （GOS）. Results The blood glucose levels in three groups on 1st day after trauma increased,blood glucose levels of severe group were significantly higher than those of mild and moderate groups （P〈0. 05）, and then blood glucose levels in three groups gradually decreased. The serum creatinine levels in three groups on lst,3rd and 7th day increased gradually, then decreased on 14th and 30th day. The serum creatinine levels of severe group on 3rd and 7th day were significantly higher than those of mild and moderate groups （P〈0. 05）. The outcomes of all patients were evaluated.. 2 cases of death, 4 cases of severe disability, 1 case of moderate disability and 1 case of good recovery in severe group, 2 cases of severe disability, 36 cases of moderate disability and 2 cases of good recovery in moder- ate group,3 cases of moderate disability and 20 cases of good recovery in mild group. Conclusion The relation between blood glucose, serum creatinine levels and GCS scores after craniocerebral trauma is obvious. The higher blood glucose and serum creatinine levels,the lower GCS scores and the more serious illness. Meanwhile the lower GCS scores, the worse outcomes.

关 键 词：颅脑外伤 血糖 血清肌酸酐 预后 

分 类 号：R651.1[医药卫生—外科学]