胰岛素强化治疗急性重型颅脑损伤的临床研究

Intensive insulin therapy in treatment of acute severe head injury

目的探讨胰岛素强化治疗对急性重型颅脑损伤的恢复及预后的影响。方法将62例急性重型颅脑损伤患者（GCS≤8）随机分为两组：对照组32例采用常规治疗；观察组30例在常规治疗的基础上加用胰岛素强化治疗。分别监测血糖水平，比较两组患者的恢复及预后情况。结果治疗后第1～6天观察组的血糖控制情况明显优于对照组，治疗后第7天两组的血糖比较差异无统计学意义；观察组的恢复良好率、病死率与对照组比较差异有显著性。结论胰岛素强化治疗急性重型颅脑损伤患者可以促进恢复，降低病死率。

Objective To investigate the influence of intensive insulin therapy on the prognosis after acute severe head injury. Methods Sixty-two patients with acute severe head injury（GCS≤8）were randomly divided into two groups： control group （n= 32） receiving conventional therapy and intensive insulin group （n= 30） receiving intensive insulin therapy besides the routine treatment, Plasma glucose was monitored and the clinical prognosis was evaluated between two groups one month after injury according to GOS scores. Results The plasma glucose of intensive insulin therapy group was better than that in control group from 1st to 6th day. There was no significant difference of plasma glucose on the 7th day. The recovery rate was 18/30 in intensive insulin therapy group, significantly higher than 8/32 in control group （P〈0. 05）. The mortality （4/30） in intensive insulin therapy group was significantly lower than that （14/32） in the control group （P〈0.05）. Conclusion Intensive insulin therapy can promote recovery and decline the mortality of patients with acute severe head injury.