摘要
目的 探讨小儿颅脑外伤急性期血糖变化与格拉斯哥昏迷评分 (GCS)和预后 (GOS)的关系 ,以及高血糖的处理。方法 测定并分析 1998年 1月至 2 0 0 2年 1月期间收治并从中选择的 14 5例颅脑外伤患儿的急性期血糖值。结果 按GCS评分分为三组 (GCS 3～ 8分 2 7例 ,9～ 12分 2 7例 ,13～ 15分 91例 ) ,入院时血糖平均值分别为 (16 .2 6± 2 .33)mmol/L、(10 .4 7± 2 .15 )mmol/L、(5 .92± 1.2 1)mmol/L ;按预后分为三组 (良好 12 6例 ,差 13例 ,死亡 6例 ) ,其入院时血糖值分别为 (7.73±3.2 5 )mmol/L、(12 .2 5± 2 .99)mmol/L、(2 2 .5 4± 3.97)mmol/L。随机选取 2 8例高血糖患儿予控制糖入量、使用胰岛素等降糖处理 ,并在伤后≤ 6h、2 4h、4 8h作血糖动态监测 ,血糖值分别为 (12 .70±3.0 2 )mmol/L、(8.34± 2 .71)mmol/L、(5 .6 3± 1.75 )mmol/L ,致残率、死亡率显著下降 ,预后良好。结论 血糖测定有助于评价小儿颅脑损伤的严重程度及预后 。
Objective To assess the relationship between the serum glucose level, Glasgow coma scale (GCS) and the prognosis in children with acute head injury. Methods From Jan.1998 to Jan. 2001, the serum glucose levels of 145 children with acute head injury on admission were analyzed. Results The patients were divided into 3 groups according to the GCS (27cases in 3～8 scores, 27cases in 9～12 scores, 91cases in 13～15 scores).Their serum glucose value were ( 16.26 ± 2.33 )?mmol/L, ( 10.47 ± 2.15 )?mmol/L, ( 5.92 ± 1.21 )?mmol/L respectively. The outcome was good in 126 patients and poor in 13 with additional 6 children deceased. The serum glucose value were( 7.73 ± 3.25 )?mmol/L and ( 12.25 ± 2.99 )?mmol/L, ( 22.54 ± 3.97 )?mmol/L on admission. Twenty eight patients had blood glucose levels continuously monitored 6,24,48 hour after the injury. The levels of serum glucose were( 12.70 ± 2.02 )?mmol/L,( 8.34 ± 2.71 )?mmol/L,and ( 5.63 ± 1.75 )?mmol/L respectively. Conclusion The serum glucose measuring is useful in evaluating the severity and prognosis of head injury in children.
出处
《中华小儿外科杂志》
CSCD
北大核心
2002年第6期540-542,共3页
Chinese Journal of Pediatric Surgery
