严重创伤患者血糖与多器官功能不全综合征和感染之间相关分析

Relationship of Hyperglycemia with MODS and Infection in Trauma Patients

目的:探讨严重创伤患者血糖与多器官功能不全综合征(MODS)和感染之间的关系。方法:随机抽查2002年12月至2004年12月本院创伤ICU患者病历1156份,根据住院期间血糖最高水平,分为血糖正常组(小于或等于6.1mmol/L)和血糖升高组(大于6.1mmol/L)。统计不同血糖水平组MODS发生率和感染率率变化。结果:(1)本院ICU创伤患者1156例血糖正常370例,占32.01%,血糖升高786例,占67.99%,严重创伤患者血糖升高百分率明显高于血糖正常百分率(P<0.01)。(2)血糖正常组370例出现MODS22例,MODS发生率为5.95%;血糖升高组786例出现MODS254例,MODS发生率为32.32%,血糖升高组MODS发生率明显高于血糖正常组(P<0.01)。(3)血糖正常组370例发生感染56例,感染率为15.14%,血糖升高组786例发生感染463例,感染率为58.91%,血糖升高组感染率明显高于血糖正常组(P<0.01)。结论:严重创伤高血糖反应与MODS、感染明显相关,血糖升高可作为创伤后MODS早期诊断指标,改善糖代谢障碍对预防和治疗创伤后感染及MODS,有重要意义。

Objective:To investigate the relationship of hyperglycemia with MODS and Infection in trauma patients. Methods: Total 1 156 trauma ICU patients from 1/12/2002 to 1/12/2004 selected randomly from our hospital, were divided into the normal glucose group and the hyperglycemia group,and the ratios of MODS and infection were calculated. Results: 1)The ratios of normal glucose in ICU of trauma was 32.01%, lower than that of hyperglycemia group(67.99%); 2) The ratios of MODS of normal glucose group in ICU of trauma was 5.95%, lower than that of hyperglycemia group(32.32%); 3)The ratios of infection of normal glucose group was 15.14%,lower than that of hyperglycemia group(80.00%). Conclusion:The hyperglycemia is correlated to the MODS and infection in trauma patients. The changes of blood glucose may contribute to the diagnosis of MODS and Infection caused by trauma. To ameliorate the disorder of glucose metabolism can help the treatment of MODS caused by trauma.