文章摘要
潘玉琴,陆红荧,周可轶,沈玮昶,张 琦,赵爱云.应激性高血糖与急性自发性脑出血患者术后并发症和早期预后的相关性研究[J].,2019,19(3):461-464
应激性高血糖与急性自发性脑出血患者术后并发症和早期预后的相关性研究
A Correlative Study on the Stress Hyperglycemia with the Postoperative Complications and Early Prognosis of Patients with Spontaneous Intracerebral Hemorrhage
投稿时间:2018-07-03  修订日期:2018-07-30
DOI:10.13241/j.cnki.pmb.2019.03.014
中文关键词: 自发性脑出血  血糖  应激性高血糖  术后并发症  预后
英文关键词: Intracerebral hemorrhage  Serum glucose  Stress hyperglycemia  Postoperative complications  Prognosis
基金项目:上海市卫生计生系统重要薄弱学科建设项目(2015ZB0304)
作者单位E-mail
潘玉琴 上海交通大学附属第一人民医院 神经外科 上海 201620 panyuqing163@126.com 
陆红荧 上海交通大学附属第一人民医院 神经外科 上海 201620  
周可轶 上海交通大学附属第一人民医院 神经外科 上海 201620  
沈玮昶 上海交通大学附属第一人民医院 神经外科 上海 201620  
张 琦 上海交通大学附属第一人民医院 神经外科 上海 201620  
赵爱云 上海市松江区泗泾医院 神经内科 上海 201601  
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中文摘要:
      摘要 目的:探讨应激性高血糖与自发性脑出血患者术后并发症及早期预后的关系。方法:回顾性分析我院收治的自发性脑出血患者358例,根据入院时血糖水平、糖化血红蛋白(HbAlc)及既往有无糖尿病史分为血糖正常组(96例)、应激性高血糖组(107例)及糖尿病组(155例),记录和比较各组入院时的血糖、格拉斯哥昏迷评分(GCS)、平均出血量及入院后30 d时各组的术后并发症发生情况、格拉斯哥预后评分(GOS)的差异。结果:糖尿病组入院时血糖水平、平均出血量、重型患者所占比率、脑出血破入脑室、颅内再出血、颅内感染、肺部感染、尿路感染及上消化道出血发生率、GOS分级植物状态或死亡发生率均明显高于应激性高血糖组(P<0.05),GOS分级良好率低于应激性高血糖组(P<0.05);而应激性高血糖组入院时血糖水平、平均出血量、重型患者所占比率、脑出血破入脑室、颅内再出血发生率、GOS分级植物状态或死亡发生率均明显高于血糖正常组(P<0.05)。结论:自发性脑出血患者入院时应激性高血糖与患者的病情显著相关,可加重急性脑出血的不良预后。
英文摘要:
      ABSTRACT Objective: To explore the relationship between stress hyperglycemia and postoperative complications and early prognosis of patients with spontaneous intracerebral hemorrhage. Methods: Three hundred and fifty-eight cases of patients with acute spontaneous intracerebral hemorrhage were involved in this retrospective analysis. According to the blood glucose level, glycated hemoglobin (HbAlc) and the history of diabetes on admission, they were divided into three groups: normal serum glucose group (96 patients), stress hyperglycemia group (107 patients) and diabetic group (155 patients). The blood glucose level, the Glasgow Coma Scale (GCS), the mean volume of the hematoma, the incidence of complication during 30 days after operation and the Glasgow Outcome Scale (GOS) were recorded and analyzed. Results: The blood glucose level, GCS, the average hematoma volume, the incidence of intracranial re-bleeding, pulmonary infection, intracranial infection, urinary tract infection, upper gastrointestinal bleeding and poor GOS prognosis in the diabetic group were higher than those in the stress hyperglycemia group (P<0.05). While the blood glucose level, GCS, the average hematoma volume, the incidence of intracranial re-bleeding, and poor GOS prognosis in the stress hyperglycemia group were higher than those in the normal blood glucose group (P<0.05). Conclusion: The level of stress hyperglycemia in patients with acute spontaneous intracerebral hemorrhage was correlated with the severity of patient's condition. Stress hyperglycemia could aggravate the short-term prognosis of acute cerebral hemorrhage.
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