重型颅脑外伤合并应激性高血糖患者控制血糖水平对预后的影响

The effects of the level of glycemic control in severe brain injury patients with stress hyperglycemia on prognosis

目的观察重型颅脑外伤合并应激性高血糖患者控制血糖水平对预后的影响。方法选取本院ICU病房收治的重型颅脑外伤患者90例，随机分为A、B、C3组，分别将血糖控制在4．4—6．1mmol／L、6．1-10．0mmol／L、10．0—11．1mmol／L。观察3组患者机械通气时间、低血糖发生率、ICU住院日及病死率等。结果A组与C组比较，A组的ICU住院日和机械通气时间比C组短，差异有统计学意义，死亡率比较无统计学意义，低血糖发生率A组较c组明显增高。A组与B组比较，A组的ICU住院日、机械通气时间比B组短，但差异无统计学意义，A组的死亡率及低血糖发生率比B组高，但差异无统计学意义。结论重型颅脑外伤患者合并应激性高血糖，将血糖控制在6．1—10．0mmol／L较为适宜，有利于降低病死率，且低血糖发生率较低。

Objective To observe the effects of the level of glyeemie control in severe brain injury patients with stress hy- perglycemia on prognosis. Methods 90 patients with severe brain injury were randomly divided into three groups, group A （target blood glueose 4.4 ~ 6.1 mmol/L）, group B （ target blood glueose 6.1 ~ 10.0mmo]/L） and group C （target blood glucose 10.0 - 11.1 mmol/L）. Observed three groups of patients ICU stay, mechanieal ventilation time, ineidenee of hypoglycemia, mortality and other indicators. Results Patients ICU stay, mechanical ventilation time of group A were significandy lower than group C, the difference was statistically significant.Mortality of group A had no statistically significant differenoe with group C.Ineidenoe of hypoglycemia of group A was significantly higher than group C.Patients ICU stay, mechanical ventilation time of group A were lower than group B,the difference was not statistically significant.Mortallty and incidence of hypoglycemia of group A were higher than group B,the difference was not statistically significant.ConclusioN The target blood glucose 6.1 - 10.0mmol/L will help to reduee mortality and incidence of hypoglycemia in severe brain injury patients with stress hyperglycemia.