摘要
目的 探讨创伤死亡患者空腹血糖变化与多器官功能不全综合征 (MODS)和存活时间之间的关系。方法 随机抽查 2 0 0 0年 1月至 2 0 0 4年 12月我院住院 3 5 7份创伤死亡患者病历 ,根据空腹血糖含量分为正常血糖组 (3 .5～ 6.1mmol/L)、轻度高血糖组 (6.1～ 8.0mmol/L)、中度高血糖组 (8.0～ 11.0mmol/L)和重度高血糖组 (>11.0mmol/L)。统计不同水平血糖患者发生MODS例数和院内存活天数 ,并分别计算创伤MODS死亡患者空腹血糖与MODS定量指标的相关系数。结果 (1) 3 5 7例创伤死亡患者正常空腹血糖 3 1例 (8.68% ) ,轻度高血糖 76例 (2 1.2 9% )、中度高血糖 10 5例 (2 9.41% )、重度高血糖 14 5例 (4 0 .62 % ) ,创伤死亡患者高血糖率明显高于正常血糖率 (P <0 .0 1)。 (2 )正常血糖组3 1例、轻度高血糖组 76例、中度高血糖组 10 5例和重度高血糖组 14 5例中 ,出现MODS例数分别为 5例 (16.13 % )、3 2例 (4 2 .11% )、82例 (78.10 % )和 117例 (80 .69% ) ,高血糖各组MODS发生率均明显高于正常血糖组 (P <0 .0 1)。 (3 )正常血糖组 3 1例、轻度高血糖组 76例、中度高血糖组 10 5例和重度高血糖组 14 5例中 3天内死亡例数分别为 2 6例 (83 .87% )、3 3例 (4 3 .42 % )、3 8例 (3 6.2 0 % )和 43例 (2 9.
Objective To investigate the relationship am on g change of hyperglycemia,MODS and survival time in dead patients caused by trau ma.Method The records of 357 dead patients caused by trauma sel ected randomly from our hospital,were divided into normal blood glucose group(3. 5～6.1mmol/L),low-grade hyperglycemia group(6.1～8.0mmol/L),mid-grade hypergly cemia group(8.0～11.0mmol/L) and high-grade of hyperglycemia group(>11.0mmol/L ).The cases of MODS and the survival time in all groups with different degree hy perglycemia were recorded,and the coefficients of relationship between the fasti ng glucose and the indexes of MODS in the dead trauma patients were calculated. Results (1)The cases of normal blood glucose,low-grade hypergl ycemia,mid-grade hyperglycemia and high-grade of hyperglycemia in all dead tra uma patients were 31(8.68%),76(21.29%),105(29.41%) and 145(40.62%).(2)The cases of MODS in 31cases of normal blood glucose,76 cases of low-grade hypergly cemia,105 cases of mid-grade hyperglycemia and 117 cases of high-grade hyperg lycemia were 5(16.13%),32(42.11%),82(78.10%) and 117(80.69%).The incidente rat es of MODS in hyperglycemia groups were significantly higher than that of normal glucose group.(3)The cases dying in 3 days in 31 cases of normal blood glucose, 76 cases of low-grade hyperglycemia,75 cases of mid-grade hyperglycemia and 11 7 cases of high-grade of hyperglycemia were 26(83.87%),33(43.42%),38(36.20%) an d 43(29.66%).(4)There were a significant positive correlation between hyperglyce mia and the indexes in?236 cases of MODS of dead patients(P<0.01).C onclusions (1)The incidence of hyperglycemia in the dead trauma patient s is higher than that in normal glucose group(such as ALT,AST,BUN,Cr,PCO 2 and CK).(2)The dead trauma patients with hyperglycemia have a high risk of MODS and a long survival time.The changes of blood glucose may contribute to the diagnosi s of MODS caused by trauma.(3)The dead trauma patients with normal blood glucose have a low risk of MODS,serious wound and a short survival time.(4)It is helpfu l to ameliorate the disorder of glucose metabolism for the treatment of MODS cau sed by trauma.
出处
《现代诊断与治疗》
CAS
2005年第2期72-74,共3页
Modern Diagnosis and Treatment
