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目的:观察分析糖尿病患者重型颅脑外伤术后脑梗死发生情况。方法:重型颅脑外伤共112例,糖尿病患者31例,非糖尿病患者81例,糖尿病患者按术后血糖控制水平分为血糖控制良好组(<16.0)和血糖控制不良组(>16.0),分别为13例、18例;所有病人均采用常规去骨瓣开颅术清除血肿减压,术后早期行脱水治疗,糖尿病组患者给予胰岛素治疗,术后1天、3天、7天复查CT。结果:糖尿病组患者15例(48.4%)出现脑梗死,血糖控制良好组和血糖控制不良组分别为3例(23.1%)、12例(66.7%),非糖尿病组患者9例(13.2%)出现脑梗死。结论:通过术后早期控制血糖水平于合适状态(<16.0),可有效降低糖尿病患者重型颅脑外伤术后脑梗死发生,明显改善患者预后。
Objective: To observe and analyze the incidence of cerebral infarction in diabetic patients with severe traumatic brain injury. Methods: A total of 112 cases of severe craniocerebral trauma, 31 cases of diabetes mellitus and 81 cases of non-diabetic patients were divided into two groups according to their postoperative glycemic control: good blood glucose control group (<16.0) and poor glycemic control group (> 16.0) 13 cases and 18 cases. All patients underwent conventional craniotomy to remove the hematoma decompression. After the operation, dehydration was performed early in the treatment. Patients in the diabetic group were given insulin therapy. CT was performed on the 1st, 3rd, and 7th day after the operation. Results: Fifteen patients (48.4%) had diabetes mellitus, and 3 patients (23.1%), 12 patients (66.7%) and 9 patients (13.2%) were non-diabetic patients with cerebral infarction. Cerebral infarction occurs. Conclusion: Controlling blood glucose level in early stage after operation (<16.0) can effectively reduce the incidence of cerebral infarction in patients with diabetes mellitus after severe traumatic brain injury and significantly improve the prognosis.