重度颅脑损伤患者血糖水平与疾病预后关系研究

目的 探讨重度颅脑损伤患者血糖水平与疾病病情、预后的关系.方法 选取我院收治的重度颅脑损伤患者87例,根据入院GCS评分,将患者分为GCS 3~5分和GCS 6~8分两组;出院时根据GOS评分,将患者分为预后良好组(GOS 4~5分)和预后不良组(GOS 1~3分);根据血糖水平分为高血糖组和非高血糖组.采用葡萄糖氧化酶法测定伤后12 h内和伤后24 h内血糖,记录高血糖组和非高血糖组的死亡率.结果 血糖与伤情:伤后12 h和24 hGCS 6~8分组患者血糖水平显著低于GCS 3~5分组(P<0.05);血糖与预后:伤后12 h和24 h预后良好组患者血糖水平显著低于预后不良组(P<0.05);非高血糖组患者预后良好(恢复良好+轻度残疾)发生率显著高于高血糖组(43.75% VS 23.07%,P<0.05),非高血糖组患者死亡率显著低于高血糖组(8.33% VS 25.64%,P<0.05).结论 重度颅脑损伤患者血糖水平与患者的病情和预后密切相关,应给予积极控制以减少死亡率.

The relationship study between blood glucose and the prognosis of the serious craniocerebral injury

Objective To explore the relationship study between blood glucose,patient’s condition and the prognosis of the serious craniocerebral injury.Methods 87 cases with serious craniocerebral injury had been admitted to our hospital.According to the GCS at admission,they were separated into GCS 3～5 scores group and GCS 6～8 scores group.According to the GOS at discharge hospital,they were divided into satisfactory group(GOS 4～5 scores)and dissatisfactory group(GOS 1～3 scores).87 cases were divided into hyperglycemia group and non-hyperglycemia group by blood glucose level.The blood glucose level of 12 and 24 h of the serious craniocerebral injury were observed,and the mortality was recorded.Results The blood glucose level of 12 and 24 h of the serious craniocerebral injury was lower in GCS 6～8 scores group than in the GCS 3～5 scores group(P<0.05).The blood glucose level of satisfactory group was lower than dissatisfactory group at 12 and 24 h of the serious craniocerebral injury.The incidence of satisfactory was higher in non-hyperglycemia group than in the hyperglycemia group(43.75% VS 23.07%,P<0.05),and the mortality was lower in non-hyperglycemia group than in the hyperglycemia group(8.33% VS 25.64%,P<0.05).Conclusion The patient’s condition and the prognosis of the serious craniocerebral injury closely to the blood glucose level,we should be treated aggressively for reduce mortality.