双C治疗减轻重度颅脑损伤患者血糖波动与预后相关性  

Study on the Correlation Between Blood Glucose Fluctuation and Prognosis in Patients With Severe Craniocerebral Injury Treated With Double C

作　　者：吴细凤[1] 林毅辉[2] 黄文森[2] WU Xifeng;LIN Yihui;HUANG Wensen(Department of Emergency,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China;Department of Endocrinology,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院急诊科,福建泉州362000 [2]福建医科大学附属泉州第一医院内分泌科,福建泉州362000

出　　处：《中国卫生标准管理》2021年第5期76-79,共4页China Health Standard Management

摘　　要：目的观察双C治疗减轻重度颅脑损伤患者血糖波动与预后相关性。方法2016年10月—2019年9月住院的94例重度颅脑损伤合并高血糖患者随机分为两组,治疗组给予双C治疗(动态血糖仪+胰岛素泵),对照组给予常规胰岛素强化治疗,在三餐前血糖达标后,以动态血糖仪监测血糖,计算平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE),比较两组住院天数、机械通气时间、死亡率、感染率、低血糖发生率、格拉斯哥昏迷评分(GCS评分)。结果 治疗组MAGE 显著低于对照组,治疗组较对照组机械通气时间显著缩短,死亡率显著下降,格拉斯哥昏迷评分在3 ~ 5 分比例显著下降(P < 0.05)。结论 双C 治疗可以减轻重度颅脑损伤合并高血糖患者血糖波动,进而缩短机械通气的时间,降低死亡率,改善患者预后。Objective Observe the correlation between blood glucose fluctuation and prognosis in patients with severe craniocerebral injury treated with double C.Methods From October 2016 to September 2019,94 patients with severe craniocerebral injury with hyperglycemia were randomly divided into 2 groups,treatment group recieved double C(dynamic glucose meter+insulin pump),the control group recieved conventional insulin intensive treatment,after the blood glucose control reached at target before meals,the blood glucose was monitored by dynamic glucose meter,the average blood glucose fluctuation(mean amplitude of glycemic excursions,MAGE)was calculated,compared two groups of hospitalization days,mechanical ventilation time and mortality rate,infection rate,incidence of hypoglycemia,Glasgow coma scale(GCS scale).Results The MAGE in the treatment group was significantly lower than the control group,the duration of mechanical ventilation was significantly shorter in the treatment group than in the control group,the mortality rate was significantly lower,and the Glasgow coma score was significantly lower on a scale of 3~5.Conclusion Double C treatment can reduce the fluctuation of blood glucose in patients with severe craniocerebral injury combined with hyperglycemia,thus shorten the time of mechanical ventilation,reduce the mortality rate and improve the prognosis of patients.

关 键 词：双C治疗 动态血糖仪 胰岛素泵 重度颅脑损伤 平均血糖波动幅度 颅脑损伤GCS评分 

分 类 号：R587[医药卫生—内分泌]