摘要
目的测定多发伤患者急性期血糖值、白细胞计数的变化,探讨其与多发伤的损伤严重度的相关性,确定血糖值和白细胞计数是否可作为判断多发伤严重度的一个客观指标。方法测定30例多发伤患者2小时内的血糖值和白细胞计数,并测定患者的血常规、血气分析、肾功能、电解质、平均动脉压、呼吸频率和心率,再结合患者的年龄及慢性生理状况对患者进行APACHEⅡ评分,将血糖值和白细胞计数分别与APACHEⅡ评分值进行相关性统计分析,并按APACHEⅡ评分值分为轻型组和重型组,比较组间血糖值和白细胞计数,并比较组间休克发生率和死亡率。结果血糖值和APACHEⅡ评分值等级相关系数r=0.962,P<0.05,表明多发伤后血糖值变化与APACHEⅡ评分值呈正相关,即随着血糖值的升高,APACHEⅡ评分值也升高;白细胞计数与APACHEⅡ评分值的相关系数r=0.970,P<0.05,表明白细胞计数与APACHEⅡ评分值亦呈正相关;当血糖值>10mmol/L或白细胞值20×109/L时,多发伤的预后很差。结论伤后2小时血糖值和白细胞计数变化是评价多发伤严重度较客观的指标,通过测定多发伤早期的血糖值和白细胞计数,可以预测多发伤病情的严重性,从而进一步提高多发伤的临床诊疗水平。
Objective We mensurate the alteration of the value of blood sugar and leukocyte count in early multiple injury,and investigate their correlation to the severity of multiple injury,and make sure whether the value of blood sugar and leukocyte count can be used as an objective index to judge the severity of multiple injury. Methods We select 30 patients and meusurate the value of blood sugar and leukocyte count of every patient who is suffered multiple injury in the early stage （within 2 hours）,and the blood routine examination,blood gas analysis,kidney function tests,electrolyte, mean arterial pressure,respiratory between the values of the blood sugar and ＂APACHE Ⅱ ＂,and so does be frequency ,heart rate are also examined, then we grade the value of APACHE Ⅱ combining with the age and chronic physiological condition, and analyze the correlation between the values of the blood sugar and ＂APACHE Ⅱ ＂,and so does between leukocyte count and ＂APACHEⅡ＂. At last we separate the patients to two groups according to the value of ＂APACHE Ⅱ ＂, one group is mild,another one is serious. Then compare the values of blood sugar and leukocyte count between two groups,we also compare the incidence of shock and the mortality in two groups. Results The coefficient of rand correlation （r） between the value of blood sugar and ＂APACHE Ⅱ ＂value is 0.962, ＂P＂ value is less than 0.05 ,which proves that the relationship between the value of blood sugar and APACHE Ⅱ value is positive in patients who suffered multiple injury. It means that when the value of the blood sugar rises, the value of ＂APACHE Ⅱ ＂ also rises. The coefficient of rand correlation （r） between leukocyte count and ＂APACHE Ⅱ ＂value is 0.970, ＂P＂ value is less than 0.05 too,which proves that the relationship between leukocyte count and ＂APACHE Ⅱ ＂value is positive too. After multiple injury,when then the value of blood sugar is more than 10mmol/ L or the amount of leukocyte count is larger than 20×10^9/L,the prognosis of every patient who is suffered multiple injury is extraordinary bad. Conclusion The values of blood sugar and leukocyte count of multiple injury at the early stage（ with 2boars ） is one of the objective index evaluating the severity of multiple injury,we can predict the severity of disease by mensurating the value of blood sugar and leukocyte count at the early stage of muhiple injury and enhance the clinic level of diagnosis and treat in multiple injury patients.
出处
《浙江创伤外科》
2009年第5期434-436,共3页
Zhejiang Journal of Traumatic Surgery
关键词
血糖
白细胞
多发伤
相关性
Blood sugar
Leukocyte count
Multiple injury
correlation
