CAJ | 학술논문

目的观察强化胰岛素治疗(ⅡT)对严重胸部创伤患者预后的影响.方法将42例严重胸部创伤患者(AIS≥3)随机分为ⅡT组(n=21,血糖控制于4.4～6.1mmol/L)和常规治疗(CIT)组(n=21,血糖控制于10.0～11.1mmol/L).观察2组治疗后住院期间的病死率,院内感染发生率,机械通气时间、ICU入住、胸腔引流管拔管和白细胞计数下降至正常所需时间.结果 2组无住院死亡,无低血糖反应.与CIT组相比,ⅡT组院内感染发生率、机械通气时间、ICU入住时间、白细胞计数下降至正常所需时间均降低,差异有统计学意义(P＜0.05)；2组在胸腔闭式引流管拔管时间、低血糖反应方面,差异均无统计学意义(P＞0.05).结论对严重胸部创伤患者ⅡT治疗可改善预后.
목적 관찰강화이도소치료(ⅡT)대엄중흉부창상환자예후적영향.방법 장42례엄중흉부창상환자(AIS≥3)수궤분위ⅡT조(n=21,혈당공제우4.4～6.1mmol/L)화상규치료(CIT)조(n=21,혈당공제우10.0～11.1mmol/L).관찰2조치료후주원기간적병사솔,원내감염발생솔,궤계통기시간、ICU입주、흉강인류관발관화백세포계수하강지정상소수시간.결과 2조무주원사망,무저혈당반응.여CIT조상비,ⅡT조원내감염발생솔、궤계통기시간、ICU입주시간、백세포계수하강지정상소수시간균강저,차이유통계학의의(P＜0.05)；2조재흉강폐식인류관발관시간、저혈당반응방면,차이균무통계학의의(P＞0.05).결론 대엄중흉부창상환자ⅡT치료가개선예후.
Objective To observe the effect of intensive insulin therapy (ⅡT) on prognosis of severe chest trauma (SCT) pateints.Methods 42 consecutive patients were randomly assigned to 2 groups:ⅡT group (n =21) and the conventional insulin therapy group (CIT group,n =21).Blood glucose was maintained at the level of 4.4 -6.1mmol/L in ⅡT group,and 10.0 -11.1mmol/L in CIT group.The 2 groups were observed in terms of fatality rate during hospital stay,infection rate,the duration of mechanical ventilation,ICU stay length,pleural drainage day and count of neutrophils.Results No death or hypoglycemic reaction happened during hospitalization.Compared to CIT group,infenction rate,mechanical ventilation time,ICU stay length,and the time required for white blood cell to resume normal in ⅡT group were decreased significantly ( P ＜ 0.05 ).The difference had no statistical significance between the 2 groups in duration of pleural drainage and incidence of hypoglycemia (P ＞ 0.05).Conclusion ⅡT improves the short-term prognosis of SCT patients.