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目的探讨胰岛素强化治疗对严重创伤患者预后的影响,研究其对危重患者脏器的保护作用。方法选择64例严重创伤患者,分为胰岛素强化治疗组和对照组,分别给予胰岛素强化治疗和常规治疗,在入院后0、2、4、6、8d留取外周静脉血,同时每日行APACHEⅡ评分,并记录反映脏器功能的生化指标和预后主要指标。结果胰岛素强化治疗实施的安全性良好。强化治疗严格控制血糖后,心功能、肝功能、肾功能不全发生率显著下降,APACHEⅡ评分降低,两组患者死亡率、院内感染发生率比较差异具有统计学意义。结论胰岛素强化治疗能有效降低ICU中危重患者脏器功能不全等并发症的发生,既降低死亡率,又减少感染出现。
Objective To investigate the effect of intensive insulin therapy on the prognosis of severe traumatic patients and to study its protective effect on organ in critically ill patients. Methods Sixty-four patients with severe trauma were selected and divided into intensive insulin treatment group and control group. Patients were given intensive insulin therapy and routine therapy respectively. Peripheral venous blood was collected at 0, 2, 4, 6 and 8 days after admission. At the same time, APACHEⅡ Score, and record biochemical indicators reflect the function of organs and the main prognostic indicators. Results Insulin fortification was performed safely. Intensive treatment of strict control of blood glucose, heart function, liver function, renal insufficiency incidence decreased significantly, APACHE Ⅱ score decreased, the two groups of patients with mortality, nosocomial infection incidence difference was statistically significant. Conclusion Intensive insulin therapy can effectively reduce the incidence of complications such as organ dysfunction in critically ill patients in ICU. It not only reduces the mortality but also reduces the incidence of infection.