急性脑出血早期高血糖对患者预后的影响

The Influence of Early Hyperglycemia on Prognosis of Patients with Acute Cerebral Hemorrhage

目的探讨急性脑出血早期高血糖对患者预后的影响。方法选择我院2008年1月～12月收治的158例无糖尿病史脑出血，并依据血糖及糖化血红蛋白分为高血糖组80例与正常血糖组78例。两组均予降颅压、调整血压，维持水、电解质平衡和营养支持等治疗，高血糖组血糖8．0mmol／L以上者结合降糖治疗。观察两组意识状态变化，包括意识清楚、嗜睡、昏睡、昏迷发生率等，并比较两组预后。结果高血糖组中意识清醒率低于正常血糖组，昏睡率、昏迷率、病死率及人院1周脑出血再发率均高于正常血糖组，差异均有统计学意义（P〈0．01）。结论重视急性脑出血早期血糖的监测，一旦发现高血糖，及时干预，以降低其致残率和病死率。

Objective To observe the influence of early hyperglycemia on prognosis of patients after acute cerebral hemorrhage, nethdds 158 cerebral hemorrhage patients without diabetes mellitus admitted in our hospital during January 2008 and December 2008 were divided into high blood glucose group （ n = 80 ） and normal blood glucose group （ n = 78 ） based on the blood glucose level. The two groups were both given corresponding treatment, such as decreasing intracranial pressure, adjusting blood pressure, maintaining water and keeping electrolyte balance and nutrition, and the patients in high blood glucose group with blood glucose up to 8.0 mmol/L were given hypoglycemic therapy. Consciousness changes in- cluding the incidence of clear consciousness, lethargy, drowsiness and coma were observed, and prognosis of the two groups was compared. Results When compared with that in normal blood glucose group, the incidence of clear consciousness, lethargy, drowsiness and coma in high blood glucose group were lower, and mortality and recurrence rates 1 week after hos＇ pitalization were higher, and the difference was statistically significant （P 〈 0. 01 ）. Conclusion Blood glucose monitoring of early acute cerebral hemorrhage is important, and it is necessary to intervene timely to reduce morbidity and mortality once hyperglycemia appears.