糖尿病患者重型颅脑外伤术后脑梗死发生的预防性治疗研究

Preventive Therapy for Postoperative Cerebral Infarction in Diabetic Patients Suffering Severe Craniocerebral Injury

目的:观察分析糖尿病患者重型颅脑外伤术后脑梗死发生情况。方法:重型颅脑外伤共112例,糖尿病患者31例,非糖尿病患者81例,糖尿病患者按术后血糖控制水平分为血糖控制良好组(<16.0)和血糖控制不良组(>16.0),分别为13例、18例;所有病人均采用常规去骨瓣开颅术清除血肿减压,术后早期行脱水治疗,糖尿病组患者给予胰岛素治疗,术后1天、3天、7天复查CT。结果:糖尿病组患者15例(48.4%)出现脑梗死,血糖控制良好组和血糖控制不良组分别为3例(23.1%)、12例(66.7%),非糖尿病组患者9例(13.2%)出现脑梗死。结论:通过术后早期控制血糖水平于合适状态(<16.0),可有效降低糖尿病患者重型颅脑外伤术后脑梗死发生,明显改善患者预后。

Objective：To observe the onsets of cerebral infarction of diabetes patients suffered severe crainocerebral injury.Methods：112 cases of severe crainocerebral injury were divided into 2 groups：31 cases in diabetes group,81 cases in non-diabetes group,diabetes group were divided into 2 groups separately：13 cases in good BG control group,18 cases in bad BG control group,after the operation of ordinary decompressive craniotomies to evacuate hematoma,all cases were treated by dehydrating agents,diabetes group were given insulin treatment,all cases were given CT scanning at 1 day,3 day and 7 day after surgery separately.Results：In diabetes group,15 patients（48.4%） presented with cerebral infarction,3（23.1%） and 12（66.7%）cases in good BG control group and bad BG control group separately,in non-diabetes group,9 patients（13.2%） presented with cerebral infarction.Conclusion：Stay with an appropriate level of postoperative BG（16.0） is an effective method of treating severe crainocerebral injury patients with diabetes to reduce the area and quantity of cerebral infarction,can also improve the prognosis markly.