强化胰岛素治疗对重型颅脑损伤患者预后的影响

Effect of intensive insulin therapy on prognosis of patients with severe head injury

目的探讨胰岛素强化治疗对重型颅脑损伤预后的影响。方法回顾性分析2006～2008年间我院收治的重型颅脑损伤伴血糖升高患者62例,其中32例进行强化胰岛素治疗,使血糖控制在4.4～6.1mmol/L,传统胰岛素治疗组30例患者血糖控制在11.1～14.0 mmol/L。观察3个月后患者的格拉斯哥预后评分(GOS)。结果比较两组的GOS,强化胰岛素治疗组的恢复良好率高于传统胰岛素治疗组,而病死率低于后者,两组之间有显著差异(P<0.05)。结论强化胰岛素治疗能改善重型颅脑损伤患者预后。

Objective To explore the clinical effect of intensive insulin treatment on the prognosis of the patients with severe head trauma. Methods 62 patients with severe head trauma and high serum glucose level were analyzed retrospectively. All patients were randomly divided into the intensive insulin therapy group（ IIT group, n = 32） which maintained serum glucose at 4.4 - 6.1 mmol/L and the conventional insulin therapy group （ CIT group, n = 30） which maintained serum glucose at 11.1 to 14. 0 mmol/L. The prognosis was analyzed by GOS scale after 3 months follow up. Results Compared with the CIT group, patients in lit group had significantly better recovery （ P 〈 0. 05 ） and lower mortality （ P 〈 0. 05 ）. Conclusion Intensive insulin therapy to maintain serum glucose at 4.4 -6.1 mmoL/L can improve the prognosis of severe head trauma.