高血压脑出血术后应激性高血糖胰岛素控制方案的治疗效果

Therapeutic effects of insulin control regimen for stress hyperglycemia after hypertensive intracerebral hemorrhage surgery

目的 探讨高血压脑出血术后发生应激性高血糖患者实施胰岛素控制方案的临床效果。方法 选取2021年1月至2022年3月淮南市第一人民医院神经外科收治的高血压脑出血患者,并在进行开颅去骨瓣减压加血肿清除术之后发生了应激性高血糖的64例患者为研究对象,按照住院号的奇偶分实验和对照组各32例,对照组患者予以常规胰岛素强化治疗,实验组实施胰岛素控制方案治疗,以患者血糖控制在7.8~9.9 mmol/L为目标,观察2组患者术后治疗的效果差异。结果 2种方案治疗后,实验组血糖达到目标值时间短于对照组,实验组应用胰岛素总量较少、实验组低血糖和高渗糖救援发生率明显较对照组低、实验组并发症率低于对照组(均P<0.05)。结论 高血压脑出血术后应激性高血糖予以胰岛素控制方案治疗可有效稳定患者血糖水平,缩短控制血糖至目标水平的时间、降低不良反应和并发症发生率,可促进患者康复,有推广价值。

Objective To investigate the clinical effects of insulin control in patients with stress hyperglycemia after hypertensive intracerebral hemorrhage surgery.Methods From January 2021 to March 2022,64 patients with hypertensive intracerebral hemorrhage admitted to the Neurosurgery Department of the Huainan First People s Hospital,who developed stress hyperglycemia after craniotomy and decompressive craniectomy plus hematoma clearance,were selected as study subjects.According to the odd-even score of the inpatient number,32 patients in the experiment group was treated with insulin control program and 32 patients in an control group were treated with conventional insulin intensive therapy.The blood sugar of patients was controlled at 7.8~9.9 mmol/L as the goal,and the difference of the therapeutic effect between the 2 groups was observed.Results After 2 different treatments,the time for blood glucose to reach the target value in the experimental group was shorter than that in the control group,the total amount of insulin used in the experimental group was less,the incidence of hypoglycemia and hypertonic glucose rescue in the experimental group was significantly lower than that in the control group,and the rate of complications in the experimental group was lower than that in the control group,(all P<0.05).Conclusion The treatment of stress hyperglycemia after hypertensive intracerebral hemorrhage with insulin control program can effectively stabilize the blood glucose level of patients,shorten the time to control blood glucose to the target level,reduce the incidence of adverse reactions and complications,and promote the rehabilitation of patients.