糖尿病对重型颅脑损伤患者预后的影响  

The Influence of Diabetes on the Prognosis of Patients with Severe Head Injury

作　　者：林令国 LIN Ling-guo(Department of Neurosurgery,Linyi Luozhuang Central Hospital,Linyi,Shandong Province,276017 China)

机构地区：[1]临沂罗庄中心医院神经外科,山东临沂276017

出　　处：《糖尿病新世界》2021年第4期52-54,共3页Diabetes New World Magazine

摘　　要：目的分析糖尿病对重型颅脑损伤患者预后的影响。方法选取该院2018年10月—2019年10月收治的60例重型颅脑损伤患者作为研究对象,分为正常血糖组、SIH组、DM组,每组20例,对比3组的血糖、乳酸、肝肾功能等指标及预后。结果入院后,正常组患者初始血糖水平为(7.8±1.3)mmol/L,乳酸为(2.6±1.3)mmol/L,血红蛋白为(111.5±25.6)g/L,白细胞为(9.9±4.2)×10^(9)/L;SIH组患者初始血糖水平为(13.1±1.5)mmol/L,乳酸为(3.0±1.2)mmol/L,血红蛋白为(103.1±21.2)g/L,白细胞为(9.7±2.7)×10^(9)/L;DM组患者初始血糖水平为(15.6±1.6)mmol/L,乳酸为(2.4±1.2)mmol/L,血红蛋白为(105.4±17.1)g/L,白细胞为(9.9±3.3)×10^(9)/L,3组患者差异有统计学意义(P<0.05),初始血糖水平:DM组>SIH组>正常组,乳酸水平:SIH组>正常组>DM组。术后28 d肺部感染发生率SIH组>DM组>正常组,差异有统计学意义(P<0.05),两两相比较,SIH显著高于正常组,差异有统计学意义(P<0.05)。术后28 d病死率SIH组>DM组>正常组,差异有统计学意义(P<0.05),SIH组>正常组、SIH组>DM组,差异有统计学意义(P<0.05)。结论应激性高血糖(SIH)较糖尿病患者、正常血糖患者的感染率高、病死率高。Objective To analyze the influence of diabetes on the prognosis of patients with severe head injury.Methods Sixty patients with severe head injury admitted to the hospital from October 2018 to October 2019 were selected as the research objects,and they were divided into normoglycemic group,SIH group,and DM group,with 20 cases in each group.The blood glucose and lactic acid,liver and kidney function and other indicators and prognosis of the three groups were compared.Results After admission,the initial blood glucose level of patients in the normal group was(7.8±1.3)mmol/L,lactic acid was(2.6±1.3)mmol/L,hemoglobin was(111.5±25.6)g/L,and white blood cells were(9.9±4.2)×10^(9)/L;the initial blood glucose level of the SIH group was(13.1±1.5)mmol/L,the lactic acid was(3.0±1.2)mmol/L,the hemoglobin was(103.1±21.2)g/L,and the white blood cell was(9.7±2.7)×10^(9)/L;the initial blood glucose level of patients in the DM group was(15.6±1.6)mmol/L,lactic acid was(2.4±1.2)mmol/L,hemoglobin was(105.4±17.1)g/L,and white blood cells were(9.9±3.3)×10^(9)/L,the differences in blood glucose and lactic acid between the 3 groups were statistically significant(P<0.05).Initial blood glucose level:DM group>SIH group>normal group,lactate level:SIH group>normal group>DM group.The incidence of pulmonary infection at 28 d postoperatively in SIH group>DM group>normal group,the difference was statistically significant(P<0.05).Compared with each other,SIH was significantly higher than that in the normal group,and the difference was statistically significant(P<0.05).At 28 d after operation,the mortality rate of SIH group>DM grouP>normal group was statistically significant(P<0.05),while SIH group>normal group,SIH group>DM group,the difference was statistically significant(P<0.05).Conclusion Stress-induced hyperglycemia(SIH)has a higher infection rate and higher case fatality rate than diabetic and normoglycemic patients.

关 键 词：应激性高血糖 重型颅脑损伤 正常血糖 糖尿病史 预后 

分 类 号：R587[医药卫生—内分泌]