控制重度颅脑损伤并发高血糖的临床意义

目的探讨胰岛素强化治疗控制重度颅脑损伤患者并发高血糖的临床意义。方法采用前瞻性对照研究方法，对收治的88名重度颅脑损伤伴高血糖患者分别采用胰岛素强化治疗（A组，n=46）和胰岛素传统治疗（B组，n=42），监测患者血糖水平，随访患者的恢复情况。结果A组感染率为30．4％，B组感染率为47．6％（P〈0．05）；A组住N1CU病房时间为（4．2±3．4）天，B组为（5．6±4．3）天（P〈0．05）；6个月内意识GCS评分好转率A组为30．4％，B组为21．4％（P〈0．05）；住院死亡率A组为26．1％，B组为26．2％（P〉0．05）。结论胰岛素强化治疗能减少重度颅脑损伤患者感染率，减少住NICU病房时间并能加快意识恢复。

Significance in treatment of hyperglycemia after severe traumatic brain injury

Objective To study the effect of intensive insulin to treat hyperglycemia after severe traumatic brain injury. Methods 88 patients with severe traumatic brain injury were randomized to two groups. Group A n=46） were treated with intensive insulin therapy and group B （n= 42） were treated with conventional glycemic therapy. Results The infection rate of group A and B were 30.4% and 47.6% （P〈0.05）. Housing days in NICU of two groups were 4. 2 ±3.4 and 5.6±4. 3（P〈0.05）. GCS recovery rate were 30. 4% and 21.4%, respectively（ P〈0.05）. The mortality was 26.1% vs. 26.2% for group A vs. group B, which was statistically not significant （P〉0.05）. Conclusion In treatment of hyperglycemia after severe traumatic brain injury, intensive insulin therapy can decline the infective rate and housing days in NICU and promote recovery.