脑出血手术患者应激性血糖水平变化与GOS评分的关系  

Relationship Between the Change of Stress Blood Glucose Level and GOS Score in Patients with Cerebral Hemorrhage Undergoing Surgery

作　　者：周建国[1] Zhou Jianguo(Neurosurgery,Nantong Third People’s Hospital,Nantong,Jiangsu,226000,China)

机构地区：[1]南通市第三人民医院神经外科,江苏南通226000

出　　处：《黑龙江医学》2024年第13期1539-1541,共3页Heilongjiang Medical Journal

摘　　要：目的:了解脑出血手术患者应激性血糖水平变化,并分析其水平与患者预后的相关性。方法:选取2017年3月—2022年3月南通市第三人民医院行手术治疗的60例脑出血患者作为研究对象,根据术前血糖水平将其分为高血糖组(n=25)与正常血糖组(n=35)。对比手术前后两组患者疾病严重程度[急性生理与慢性健康评分(APACHEⅡ)]、意识障碍程度[格拉斯哥昏迷量表(GCS)]变化,观察两组患者预后效果[格拉斯哥预后量表(GOS)]以及不良事件(再出血、感染、死亡)发生情况。结果:术后,两组患者APACHEⅡ均较术前明显降低,且正常血糖组患者APACHEⅡ评分明显低于高血糖组,差异有统计学意义(t=2.949,P<0.05);两组患者GCS评分均较术前明显升高,且正常血糖组患者GCS评分明显高于高血糖组,差异有统计学意义(t=2.720,P<0.05);正常血糖组患者预后效果较高血糖组明显更高,差异有统计学意义(Z=5.306,P<0.05);两组患者不良事件发生率比较,差异无统计学意义(χ^(2)=0.116,P>0.05)。结论:脑出血手术患者应激性血糖变化与GOS评分呈正相关,应激性血糖水平越高,患者疾病严重程度越高,预后效果越差。Objective:To investigate the change of stress blood glucose level in patients with cerebral hemorrhage undergoing surgery,and analyze the correlation between the level and the prognosis of patients.Methods:60 patients with cerebral hemorrhage who underwent surgical treatment in the hospital from March 2017 to March 2022 were selected as the study objects,and they were divided into hyperglycemia group(n=25)and normal glucose group(n=35)according to the preoperative blood glucose level.The changes of disease severity[APACHEⅡ]and consciousness disorder[Glasgow Coma Scale(GCS)]of patients in the two groups before and after surgery were compared.The difference of prognosis[Glasgow Outcome Scale(GOS)]and adverse events(rebleeding,infection and death)between the two groups were observed.Results:After surgery,the APACHEⅡscore in both groups was significantly lower than that before surgery,and the APACHEⅡscore in normal blood glucose group was significantly lower than high blood glucose group,with statistical significance(t=2.949,P<0.05).GCS scores in both groups were significantly higher than before surgery,and GCS scores in normal blood glucose group were significantly higher than high blood glucose group,the difference was statistically significant(t=2.720,P<0.05).The prognosis effect of normal blood glucose group was significantly higher than high blood glucose group,and the difference was statistically significant(Z=5.306,P<0.05).There was no significant difference in the incidence of adverse events between the two groups(χ^(2)=0.116,P>0.05).Conclusion:There is positive correlation between the change of stress blood glucose and GOS score in patients with cerebral hemorrhage undergoing surgery.The higher the stress blood glucose level is,the more the disease severity and the worse the prognosis is.

关 键 词：脑出血 应激性血糖水平 疾病严重程度 意识障碍 预后 

分 类 号：R543.34[医药卫生—心血管疾病]