急性颅脑损伤患者血糖水平与预后的关系探讨

Exploration on the relationship between the level of blood glucose and prognosis in acute craniocerebral injury patients

目的探讨急性颅脑损伤患者血糖水平的变化与颅脑损伤程度及预后的关系。方法 118例急性颅脑损伤患者入院后检测血糖,并在第1周内隔天检测血糖,2～4周每周检测血糖一次,取入院时和1个月血糖水平,分析血糖水平与GCS评分、病死率、预后之间的关系。结果 GCS评分与预后存在相关性:入院时正常血糖组(3.6～6.4mmol/L)GCS评分较高,较高血糖水平组(>6.4～11.0mmol/L)GCS评分较低,高血糖水平组(>11.0mmol/L)GCS评分最低,三者比较差异有统计学意义(P<0.05);入院时正常血糖组病死率为0(0/34),较高血糖水平组病死率3.5%(2/57),高血糖水平组病死率最高,为22.2%(6/27),三者之间差异有统计学意义(P<0.05);经过控制血糖1个月后,大部分患者血糖水平均下降,正常血糖组病死率为0(0/80),较高血糖水平组病死率13.0%(3/23),高血糖水平组病死率最高,为33.3%(5/15),三者之间差异有统计学意义(P<0.05)。结论急性颅脑损伤后血糖水平可作为判断颅脑损伤严重程度及预后的一个指标,患者血糖水平越高,预后愈差。

Objective To investigate the relationships among the level of blood glucose（BG） and injury degree and prognosis in craniocerebral injury patients.Methods The levels of BG in 118 patients with craniocerebral injury were detected on admission,and detect BG every other day one week after treatment,and one time every week from two to four weeks.The relationships among BG,GCS scores,ratio of death,and the prognosis were analyzed by SPSS software.Results There was relationship between GCS scores and prognosis.On admission,there were significant differences among euglycemia groups（EG）,higher level of BG（HBG） and hyperglycemia（HG） in GCS scores（P0.05）.The ratios of EG,HBG,and HG were 0（0/34）,3.5%（2/57）and 22.2%（6/27）,respectively.And there were significant differences among them（P0.05）.After the control of BG one month later,the ratios of EG,HBG,and HG were 0（0/80）,13.0%（3/23） and 33.3%（5/15）,respectively.And there were significant differences among them（P0.05）.Conclusion The level of BG could be a index of injury degree and prognosis in acute craniocerebral injury patients,and the higher of BG level,the poorer of the prognosis.