CAJ | 학술논문

目的：探讨创伤患者早期应激血糖升高对继发感染的影响。方法回顾性分析2010年10月～2013年9月急诊入住我科82例创伤患者的临床资料，根据患者入院2 h内、2～24 h与24～48 h的应激血糖情况，评出相应分值，然后算出三者之和的总分值，根据总分值的大小确定应激血糖级别，分为Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级。分析各级应激血糖与患者住院期间发生的继发感染和平均住院时间的关系。结果82例患者中，血糖分值Ⅰ级22例（26．8％）、Ⅱ级34例（41．5％）、Ⅲ级17例（20．7％）、Ⅳ级9例（11％），应激血糖级别为Ⅲ、Ⅳ级创伤患者发生继发感染的百分率明显高于Ⅰ、Ⅱ级患者（57．7％ vs10．7％，P＜0．01），平均住院时间显著延长（17．20dvs6．09d，P＜0．01）；Ⅰ级与Ⅱ级血糖升高患者继发感染发生率差异无显著意义（P＞0．05）。结论创伤患者应激血糖升高是继发感染和住院时间延长的重要因素之一，对患者病情进展有不利的影响，应引起临床工作者高度重视。
목적：탐토창상환자조기응격혈당승고대계발감염적영향。방법회고성분석2010년10월～2013년9월급진입주아과82례창상환자적림상자료，근거환자입원2 h내、2～24 h여24～48 h적응격혈당정황，평출상응분치，연후산출삼자지화적총분치，근거총분치적대소학정응격혈당급별，분위Ⅰ급、Ⅱ급、Ⅲ급、Ⅳ급。분석각급응격혈당여환자주원기간발생적계발감염화평균주원시간적관계。결과82례환자중，혈당분치Ⅰ급22례（26．8％）、Ⅱ급34례（41．5％）、Ⅲ급17례（20．7％）、Ⅳ급9례（11％），응격혈당급별위Ⅲ、Ⅳ급창상환자발생계발감염적백분솔명현고우Ⅰ、Ⅱ급환자（57．7％ vs10．7％，P＜0．01），평균주원시간현저연장（17．20dvs6．09d，P＜0．01）；Ⅰ급여Ⅱ급혈당승고환자계발감염발생솔차이무현저의의（P＞0．05）。결론창상환자응격혈당승고시계발감염화주원시간연장적중요인소지일，대환자병정진전유불리적영향，응인기림상공작자고도중시。
Objective To explore the effect on secondary infection for trauma patients with early stress hypergly-cemia .Method Retrospective analysis was used to analyze the clinical data of 82 traumatic patients in our emergency department from October 2010 to September 2013 .Marks was given and caculated according to the patients’ blood glucose change in 2 ,2~24 and 24~48 hours .Then confirm Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ stress blood glucose levels according to the total marks ,The relationship between he stress blood glucose change at all levels and the secondary infections in patients during hospitalization was analyzed .Result There were 22 cases (26 .8% ) for I level ,34 cases(41 .5% ) forⅡ level ,17 cases(20 .7% ) forⅢ level ,9 cases(11% ) for Ⅳ level .The percentage of occurrence in secondary infec-tion was significantly higher in the Ⅲ and Ⅳ levels than that of Ⅰ and Ⅱ levers for trauma patients (57 .7% vs 10 .7% ,P<0 .01) .The average length of hospital stay was also significantly extended (17 .20 days vs 6 .09 days ,P<0 .01) .There was no significant difference betweenⅠ and Ⅱlevers for the occurrence of the secondary infection (P>0 .05) .Conclusion One of the important factors for the secondary infection and prolonged hospitalization was the changes of traumatic stress blood glucose ,which have adverse effect on patients’ disease progression .Clinical nurse should pay more attention to their changes of traumatic stress blood glucose .