院前颅脑创伤患者创伤程度与早期血糖相关性分析

Analysis of the relationship between prehospital brain trauma severity grade and plasma glucose concentration

目的 检测院前颅脑创伤患者创伤程度与早期血糖之间的关系,以指导院前创伤患者的病情评估与预后.方法 回顾性分析2008-01～2010-12期间43例院前颅脑创伤患者创伤程度与其早期血糖之间的关系,根据格拉斯哥昏迷评分（GCS）分为轻、中、重度颅脑创伤三组,按上海市院前急救质控手册,分为病情判断危重和普通组,用t检验进行组间比较,评估早期血糖与患者伤情、预后的关系.结果 研究显示,轻、中、重度颅脑伤患者出现不同程度的高血糖,平均血糖随着伤情的加重依次升高,其中GCS评分在13～15分之间为轻度创伤组,共21例,血糖为（5.62±0.67）mmol/L;GCS评分在9～12分之间为中度创伤组,共13例,血糖为（6.38±0.44 ）mmol/L;GCS评分在3～8分之间为重度创伤组,共9例,血糖为（7.33±1.48）mmol/L;病情危重组血糖值为（7.62±0.54）mmol/L,病情普通组血糖值为 （5.85±0.89）mmol/L.结果 表明,轻、中型颅脑创伤组间差异无统计学意义（P〉0.05）,其余两两组间差异均有统计学意义（P〈0.05）;病情判断危重和普通组比较差异有统计学意义（P〈0.05）.结论 院前颅脑创伤患者创伤严重程度与早期血糖增高有明显正相关性,对院前创伤患者的病情评估与预后有指导意义.

Objective To study the relationship between prehospital brain trauma severity grade and plasma glucose concentration in order to instruct prehospital brain trauma assessment and prognosis.Methods A retrospective analysis of 43 patients with brain trauma from Jan. 2008 - Dec. 2010 was carried out. Patients were classified into three groups （the mild, the moderate and the severe） base on their Glasgow Coma Scale. Plasma glucose of all the patients were tested. Patients were classified into two groups （ serious patients, non - serious patients） base on Shanghai Pre - hospital First - aid Quality Control Manual. T test was used to analyze the relationship of brain trauma severity grade with the patients＇plasma glucose concentration. Results 21 patients Glasgow Coma Scale was 13 ~ 15（the mild injury group） ; 13 patients＂ Glasgow Coma Scale 9 - 12 （ the moderate injury group ） ; 9 patients with Glasgow Coma Scale 3 -8 （the severe injury group）. The plasma glucose were （5.62 ± O. 67 ） mmol/L in the mild injury group and （6.38 ±0.44 ） mmol/L in the moderate injury group, （7.33 ±l. 48） mmoL/L in the severe group. The plasma glucose were （ 7. 62 ± 0. 54 ） mmoL/L in the serious patients and （5.85±0.89） mmol/L in the non - serious patients. Results showed no obvious difference between the mild and the moderate injury group（ P 〉 0.05 ）. There was obvious difference between the moderate and severe injury group （ P 〈 O. 05 ） , between the mild and the severe injury group （ P 〈 O. O1 ）. Serious patients and non- serious patients also had obvious difference （P 〈 0.05 ）. Conclusion There are obviously positive correlation between patients＇ brain trauma severity grade and their plasma glucose.