强化胰岛素治疗重型颅脑损伤的前瞻性研究

【摘要】〓目的〓比较强化胰岛素治疗与常规胰岛素治疗两种方法在治疗重型颅脑损伤患者上的预后差异。方法〓以2012年1月至2014年6月在我院进行治疗的重型颅脑外伤且合并应激性高血糖的116例患者为研究对象,按病情、年龄、性别等因素配对分成两组,将应用强化胰岛素治疗的58名患者为实验组,将常规胰岛素治疗的58例患者为对照组,并以死亡率、神经功能恢复情况、院内感染率、低血糖发生率为指标分析两组患者的预后差异。结果〓实验组和对照组两组死亡率差别无统计学意义,但实验组院内感染发生率低于对照组,实验组神经功能恢复情况优于对照组,实验组低血糖发生率高于对照组。结论〓强化胰岛素治疗能降低重型颅脑损伤患者院内感染发生率,并利于患者神经功能恢复,但需警惕其可能诱发患者低血糖的风险。

Prospective study of the intensive insulin therapy for severe traumatic brain injury

【Abstract】〓Objective〓To compare the outcomes between intensive insulin therapy (IIT) and conventional insulin therapy(CIT) in patients with severe traumatic brain injury. Methods〓A retrospective study was preformed, including 116 severe traumatic brain injury patients complicated with stress hyperglycemia from our hospital during Jan 2012 to June 2014. The patients were paired and divided into two groups according to the condition, age and gender. The patients in group A were treated with IIT regimen and those in group B received CIT. The mortality, neurological function, nosocomial infection and hypoglycemia were recorded, analyzed and cpmpared between two groups. Results〓There was no statistical significance of the mortality between group A and B. Group A was associated with a lower incidence of nosocomial infection than group B. The neurological functional recovery of group A was better than that of group B. The hypoglycemia risk of group A was higher than that of group B. Conclusion Intensive insulin therapy can reduce nosocomial infection and have benefit in the neurological recover, but takes a risk of hypoglycemia.