不同血糖控制方案对脑出血术后应激性高血糖患者预后及血糖的影响

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1、不同血糖控制方案对脑出血术后应激性高血糖患者预后及血糖的影响［摘要］目的探讨不同血糖控制方案对脑出血术后应激性高血糖患者预后及血糖的影响。方法采用回顾性研究方法将2015年6月〜2016年5月入住我院重症医学科的52例脑出血术后应激性高血糖患者根据血糖控制方案的不同分为A组和B组，A组采用静脉单次推注，B组采用持续静脉泵注。比较两组的28d生存率、格拉斯哥预后评分、血糖达标率、达标时间、血糖监测次数、低血糖发生率、血糖水平和血糖变异度指标的差异。结果两组的28d生存率、血糖达标率、达标时间、低血糖发

2、生率比较，差异无统计学意义。A组的格拉斯哥预后评分显著高于B组，差异有统计学意义。A组的血糖监测次数显著少于B组，差异有统计学意义。A组的血糖最大值和血糖差值均显著小于B组，差异有统计学意义。结论静脉单次推注胰岛素能够改善脑出血术后应激性高血糖患者的神经功能预后，可以降低入ICU后血糖最大值和血糖差异。［关键词］血糖控制；脑出血术后；应激性尚血糖；预后［中图分类号］R743.34［文献标识码］A［文章编号］1674-472106-0038-03[Abstract]ObjectiveToinvesti

3、gateinfluenceofdifferentbloodglucosecontrolprogramsonprognosisandbloodglucoseinpatientswithintracerebralhemorrhageafteroperationtogetherwithstresshyperglycemia.MethodsAretrospectivestudywasconducted，and52patientswithstresshyperglycemiaaftercerebralhemo

4、rrhageinourhospitalfromJune2015toMay2016weredividedintogroupAandgroupBaccordingtodifferentbloodglucosecontrolprograms.GroupAwastreatedwithintravenousbolusinjection，andgroupBwastreatedwithcontinuousintravenouspump.The28dsurvivalrate，theGlasgowoutcomesco

5、re,thebloodglucosecompliancerate，thestandardtime，thefrequencyofbloodglucosemonitoring，theincidencerateofhypoglycemia,bloodglucoselevelsandbloodglucosevariabilityindexeswerecomparedbetweenthetwogroups.ResultsTherewasnosignificantdifferencein28dsurvivalr

6、ate,thebloodglucosecompliancerate，thestandardtime，theincidencerateofhypoglycemiabetweenthetwogroups.TheGlasgowoutcomescoreingroupAwassignificantlyhigherthanthatingroupB，withsignificantdifference.ThenumberofbloodglucosemonitoringingroupAwassignificantly

7、lessthanthatingroupB，withsignificantdifference.TheGlumaxandGludifingroupAwassignificantlylessthanthatingroupB，withsignificantdifference.ConclusionIntravenoussinglebolusinsulininjectioncanimprovetheprognosisofnervousfunctioninpatientswithintracerebralhe

8、morrhageafteroperationtogetherwithstresshyperglycemia，andcanreducethemaximumbloodglucoseandbloodglucosedifferenceafterICU.［Keywords］Bloodglucosecontrol；Intracerebralhemorrhageaftersurgicaloperation；Stresshyperglycemia；Prognosis脑出血是指原发性脑