重症脑出血患者个体化血糖管理的临床意义及预后*
Clinical Significance and Prognosis of Individualized Glycemic Management of the Patients with Severe Cerebral Hemorrhage*

DOI: 10.12677/ACREM.2013.12004, PP. 9-12

Keywords: 重症脑出血；血糖；胰岛素；预后
Severe Cerebral Hemorrhage, Glycemia, Insulin, Prognosis

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Abstract:

目的：评价标准化胰岛素强化治疗对重症脑出血患者预后的影响。方法：451例重症脑出血(GCS评分≤ 8)伴血糖异常升高患者，随机分为胰岛素强化治疗组和常规治疗组，观察治疗30天后病死率。结果：胰岛素强化治疗组和常规治疗组30天的病死率分别是47.79%和41.33%，差异没有统计学意义(P > 0.05)。接受胰岛素强化治疗的226例患者中，GHb升高组病死率明显高于GHb正常组(57.14% vs 40.63%，P = 0.01)。接受胰岛素常规治疗的225例患者中，GHb正常组病死率显著高于GHb升高组(49.65% vs 27.38%，P = 0.001)。结论：重症脑出血患者入院时就应该立即测定GHb，进而制定个体化血糖管理目标和胰岛素治疗策略。

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