急性创伤性颅脑损伤患者围手术期血糖变化与颅脑损伤严重程度的相关性

发布时间：2018-06-21 12:40

本文选题：急性创伤性颅脑损伤 + 血糖变异度　；参考：《中国医科大学学报》2016年04期

【摘要】：目的探讨急性创伤性颅脑损伤患者围手术期血糖变化与颅脑损伤程度的相关性。方法回顾性分析2012年7月至2015年6月于中国医科大学附属第一医院神经外科住院治疗的125例满足研究标准的急性单发性创伤性颅脑损伤患者的临床资料,根据患者入院时的格拉斯哥昏迷评分(GCS)分组:对照组(GCS 15分)、轻型组(GCS 13~14分)、中型组(GCS 9~12分)、重型组(GCS 6~8分)和特重型组(GCS 3~5分),入院后即开始进行血糖控制(包括缓解应激因素和应用胰岛素),分别统计患者入院后的每日血糖,然后计算各组在不同时间段内的血糖均数、血糖标准差及血糖变异系数,分析患者血糖变异度和高血糖的持续时间与患者颅脑损伤严重程度的关系。结果同一时间段特重型组和重型组的血糖均数、血糖标准差及血糖变异系数均明显高于对照组(P0.05);同一组中,在入院时、入院48 h和入院3~7 d不同的时间段间,患者的血糖均数、血糖标准差和血糖变异系数均有统计学差异(P0.05);特重型组和重型组患者高血糖平均持续时间和意识障碍平均持续时间与对照组相比均有统计学差异(P0.05)。秩相关分析表明,血糖整体水平、血糖波动度以及高血糖平均持续时间与患者颅脑损伤严重程度呈正相关(r1)。结论急性单发性创伤性颅脑损伤患者血糖变化水平可以作为重型颅脑损伤病情严重程度的评价指标。
[Abstract]:Objective to investigate the relationship between perioperative blood glucose and degree of acute traumatic brain injury. Methods from July 2012 to June 2015, the clinical data of 125 patients with acute traumatic craniocerebral injury who were hospitalized in the Neurosurgery Department of the first affiliated Hospital of China Medical University were retrospectively analyzed. According to the Glasgow coma score (GCS) on admission, the control group (GCS 15), the light group (GCS 13 ~ 14), the medium group (GCS 9 ~ 12), the severe group (GCS 6 ~ 8) and the extra severe group (GCS 3 ~ 5), the blood glucose was controlled immediately after admission. Including relieving stress factors and using insulin, the daily blood sugar levels of patients after admission were counted respectively. Then the mean of blood sugar, standard deviation of blood glucose and coefficient of variation of blood glucose were calculated in different time periods, and the relationship between blood glucose variation and duration of hyperglycemia and the severity of craniocerebral injury was analyzed. Results the mean of blood glucose, standard deviation of blood glucose and coefficient of variation of blood glucose in the severe and severe groups were significantly higher than those in the control group in the same time period (P 0.05), and in the same group, the mean of blood sugar in the patients was significantly higher than that in the control group at the time of admission, 48 hours after admission and 3 days after admission. The mean duration of hyperglycemia and the mean duration of disturbance of consciousness in severe and severe patients were significantly different from those in control group (P 0.05). Rank correlation analysis showed that the overall blood glucose level, blood glucose fluctuation and mean duration of hyperglycemia were positively correlated with the severity of craniocerebral injury. Conclusion the level of blood glucose in patients with acute traumatic brain injury can be used as an index to evaluate the severity of severe brain injury.
【作者单位】：中国医科大学附属第一医院神经外科;中国医科大学附属盛京医院急诊科;海南医学院附属医院急危重症医学部;河北北方学院第一附属医院神经外科;
【基金】：教育部留学回国人员科研启动基金(教外司留[2013]1792号) 辽宁省自然科学基金(2015020460;2013021083) 沈阳市科技创新专项基金人口与健康科技攻关专项(F13-220-9-53)
【分类号】：R651.15

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