应激性高血糖治疗中低血糖反应的临床分析

Clinical Analysis of Hypoglycemia Response during Treatment of Stress Hyperglycemia

目的 :探讨危重症患者应激性高血糖治疗中低血糖的危害、原因及对策。方法 :将 31例应激性高血糖患者分成二组。A组 :治疗中未出现低血糖组 ,B组 :治疗中出现低血糖组。分别观察两组患者的APACHE Ⅱ评分、多器官功能障碍综合征 (MODS)发生率及病死率。结果 :B组患者的病死率 (10 0 % )及MODS发生率 (88.9% )均较A组 (5 0 % ,31.8% )高 (P <0 .0 1) ;B组患者的A PACHE Ⅱ评分 (19.33± 2 .6 5 )与A组 (7± 2 .12 )比较有统计学差异 (P <0 .0 1)。结论 :危重症患者应激性高血糖治疗中发生低血糖的危害大 。

Objective: To investigate the harmfulness, causes and treatments of hypoglycemia during treatment of stress hyperglycemia in patients with critically ill disorders. Methods: 31 patients with stress hyperglycemia were divided into 2 groups. Group A: no hypoglycemia. Group B: with hypoglycemia. The APACHE II scores, morbidity of multiple organ disturbance syndrome (MODS) and mortality rate were evaluated. Results: Both the mortality rate and morbidity of MODS in group B were higher than those in group A ( P < 0.01 ). There was a significant difference in APACHE Ⅱ score between group A and group B( P < 0.01 ). Conclusion: The harmfulness of hypoglycemia occurred secondary to treatment of stress hyperglycemia in patients with critically ill disorders is so significant that all measures should be taken to prevent the appearance of hypoglycemia.