糖代谢障碍与极化液治疗对创伤后器官损害及预后的影响

The roles of glucose metabolism disorder and treatment with GIK on organ dysfunction in patients after trauma

目的：探讨糖代谢障碍与极化液治疗对创伤后器官损害及预后的影响,为极化液辅助改善创伤后器官损伤提供依据。方法：2002年1月至2004年1月我院创伤ICU病房收治的患者,随机分为极化液辅助治疗组和常规治疗组,制订创伤患者个体化极化液临床干预理论和经验公式,观察不同治疗组创伤患者空腹血糖、空腹乳酸、血CRP、TNFα和IL-1β水平变化,以及器官损伤发生率、器官损伤患者病死率和器官损伤死亡患者在创伤整体患者的百分比变化。结果：极化液辅助治疗组空腹血糖、空腹乳酸、血CRP、TNFα和IL-6水平变化,以及器官损伤发生率和器官损伤死亡患者在创伤整体患者的百分比均明显低于常规治疗组(P＜0．01或0．05),极化液治疗组器官损伤患者病死率虽然下降,但与常规治疗组无显著差别。结论：糖代谢障碍在创伤后器官损伤中发挥重要作用,极化液个体化治疗通过改善糖代谢障碍和降低炎症细胞因子水平,对创伤后器官损伤有辅助治疗和预防作用,值得临床推广。

Objective:To study the roles of glucose metabolism disorder and treatment with GIK on organ dys- function in patients after trauma.Methods:Trauma patients in ICU of our hospital admitted from January 2002 to January 2004 were divided into the glucose-insulin-potassium(GIK)treatment group and conventional treatment group.The levels of glucose,lactic acid,CRP,TNFa,IL-1β,and the percentage of organ dysfunction,as well as mortality in both groups were observed and compared.Results:The levels of glucose,lactic acid,CRP,TNFα,IL- 1β.and percentage of organ dysfunction in the GIK treatment group were lower than those in the conventional treatment group.There was no significant difference in the mortality rate between GIK and conventional treatment groups.Conclusions:Disorder of glucose metabolism might play an important role in the development of multiple organ dysfunction,and GIK treatment appears to be beneficial for the prevention of organ dysfunction caused by trauma.