摘要
目的:通过对严重创伤患者围手术期采用胰岛素强化强化的综合护理原则,探讨胰岛素强化治疗对肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)的变化规律及其相关性。方法:64例发生应激性高血糖(血糖值超过肾糖阈8.96mmol/L)的SIRS患者,配对后随机分为胰岛素强化治疗组和常规治疗组,分别在治疗前和治疗后进行检测血糖水平以及综合护理,采用放射免疫法和ELISA法分别于治疗后12小时,以及术后24小时、48小时检测两组血浆TNF-a与IL-6水平。结果:严重创伤患者早期胰岛素强化治疗后,手术后血中炎症介质TNF的水平虽著下降(P<0.01),而血IL-6的水平也显著降低(P<0.01)。结论:针对胰岛素强化治疗看发生的病理生理变化,制定综合护理原则。严重创伤患者围手术期胰岛素强化治疗可以显著降低血浆TNF-a、IL-6的炎性介质水平,继而抑制创伤后全身炎症反应综合征的发生,预防感染,提高手术成功率和患者生存率。
Objective：To explore the expression of tumor necrosis factor（TNF） and inter leukin-（IL-6） in serum and their effect to the prognosis after intensive insulin therapy in critically ill patients before and after operation, Methods：64 critically ill patients were randomly divided into intensive insulin therapy group and control group, ILIA and ELISA methods were used to determine the TNF and IL-6 levels on 12h before operation and on （24-48）h after operation. Results：levels of TNF and IL-6 in critically ill patients were Significantly lower in intensive insulin therapy than that in control group （p〈0.01）, Conclusion：The nursing plan is made by means of pathological changes after intensive insulin therapy .The alteration of TNF and IL-6 are obvious in critically ill patients with intensive insulin therapy before and after operation, and the mechanism may be related to inhibiting inflammatory response induced by cytokines.
出处
《中国医药导刊》
2009年第9期1566-1567,共2页
Chinese Journal of Medicinal Guide
