强化胰岛素治疗对ICU重症颅脑损伤和并应激性高血糖患者预后的影响  

The Effect of Intensive Insulin Therapy on the Prognosis of Patients with Severe Brain Injury and Stress Hyperglycemia in ICU

作　　者：林长亮 冯星火[1] LIN Changliang;FENG Xinghuo(Department of Critical Medicine,Liaoning People's Hospital,Shenyang 110016,Liaoning Province,China)

机构地区：[1]辽宁省人民医院重症医学科,沈阳110016

出　　处：《中国实用乡村医生杂志》2020年第4期70-72,共3页Chinese Practical Journal of Rural Doctor

摘　　要：目的 探讨强化胰岛素治疗对重症医学监护室(ICU)重症颅脑损伤并应激性高血糖患者预后的影响.方法 收集2015年1月—2018年12月辽宁省人民医院收治的重度颅脑损伤(sTBI)并应激性高血糖患者260例,随机分为对照组和观察组各130例.两组均采用胰岛素微泵注射控制血糖,对照组将血糖控制在6.1~11.0 mmol/L;观察组将血糖控制在<6.1 mmol/L.比较两组两组血糖波动情况、住院治疗情况和随访情况.结果 两组D1、D3、D5、D7血糖差异均有统计学意义(P<0.05).两组机械通气时间、ICU治疗时间和总住院时间差异均有统计学意义(P<0.05).两组院内感染、死亡发生情况差异均有统计学意义(P<0.05).结论 强化胰岛素治疗能够进一步加快患者恢复速度,减少不良预后结局,应视为sTBI并应激性高血糖的诊治策略之一.Objective To investigate the effect of intensive insulin therapy on the prognosis of severe brain injury and stress hyperglycemia patients in intensive care unit(ICU).Methods From January 2015 to December 2018,a total of 260 patients admitted to Liaoning People's Hospital with severe brain injury(STBI)and stress hyperglycemia were randomly divided into control group and observation group,130 cases in each group.Both groups were injected with insulin micropump to control blood glucose.The control group controlled blood glucose at 6.1?11.0 mmol/L,and the observation group controlled blood glucose less than 6.1 mmol/L.Blood glucose fluctuation,hospitalization and follow-up were compared between the two groups.Results There were significant differences in blood glucose at D,,D3,D5,and D7 between the two groups(P<0.05).There were significant differences in mechanical ventilation time,ICU treatment time and total hospitalization time between the two groups(P<O.O5).There were significant differences in the incidence of nosocomial infection and death events between the two groups(P<0.05).Conclusion Intensive insulin therapy can further speed up the recovery of patients and reduce the adverse outcome.It should be considered as one of the diagnosis and treatment strategies for STBI with stress hyperglycemia.

关 键 词：颅脑损伤 重症 应激 高血糖 胰岛素 强化治疗 预后 

分 类 号：R558[医药卫生—血液循环系统疾病]