严重创伤患者血糖水平与多器官功能不全综合征和感染的相关性分析

摘要

Objective:To investigate the relationship of hyperglycemia with MODS and Infection intrau-ma patients.Method: Total 498 trauma patients from Jan.2010 to Jun.2012 selected randomly from our hospital, were divided into the normal glucose group and the hyperglycemia group , and the ratios of MODS and infection were calculated .Result: The ratios of normal glucose in trauma patients was 22.89%, which was lower than that of hyperglycemia group ( 77.11%);The ratios of MODS of normal glucose group in trau -ma patients was 24.56%, which was lower than that of hyperglycemia group ( 713.5%);The ratios of infec-tion of normal glucose group was 29.82%, which was lower than that of hyperglycemia group ( 846.4%);There was positive correlation between the hyperglycem ia and the indexes of MODS of dead trauma patients ( P<0.01) .Co nclusion:The hyperglycemia is correlated to the MODS and infection in trauma patients .The changes of blood glucose may contribute to the diagnosis of MODS and infection caused by trauma .To amelio-rate the disorder of glucose metabolism can help the treatment of MODS caused by trauma .%目的：探讨严重创伤患者血糖与多器官功能不全综合征（ MODS ）和感染之间的关系。方法：随机抽查2010年1月至2012年6月本院住院部和创伤急救中心患者病历498份，根据患者血糖水平分为正常组（≤6．1mmoL／L）和升高组（＞6．1mmoL／L）。统计不同血糖水平组MODS发生率和感染率变化。结果：创伤患者498例血糖正常114例，占22．89％，血糖升高284例，占77．11％，严重创伤患者血糖升高百分率明显高于血糖正常百分率（ P＜0．01）；血糖升高组384例发生感染325例，感染率为84．64％，出现MODS274例，MODS发生率为71．35％；血糖正常组114例发生感染34例，感染率为29．82％，出现MODS28例，MODS发生率为24．56％，血糖升高患者感染率和MODS发生率均显著高于血糖正常患者（ P＜0．01）；274例创伤死亡MODS患者空腹血糖（ mmoL／L）与ALT、AST、BUN、Cr、PCO 2、CK明显正相关；血糖升高患者伤情明显比血糖正常患者严重，且3d内死亡构成比显著高于血糖正常者。结论：严重创伤高血糖反应与MODS、感染明显相关，血糖升高用作MODS早期诊断及创伤后感染防治。