本文選題：早期血糖 + 因素　； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析總結(jié)近年來我科重度以上燒傷病人早期血糖變化情況,探討嚴重?zé)齻缙谘亲兓挠绊懸蛩?及其對臨床預(yù)后的影響,為今后臨床診治提供參考借鑒。方法:收集自2013年1月至2016年5月我院燒傷整形外科所收治的122例重度和特重度燒傷患者的臨床資料,包括患者的年齡、性別、有無休克延遲復(fù)蘇、燒傷原因、燒傷面積、吸入性損傷發(fā)生率、早期隨機血糖、全身性感染發(fā)生率、死亡率、住院時間、感染部位數(shù)量以及MODS發(fā)生率。應(yīng)用SPSS19.0統(tǒng)計學(xué)軟件進行T檢驗等統(tǒng)計分析.結(jié)果:通過單因素分析,燒傷面積與早期血糖具有線性關(guān)系,相關(guān)系數(shù)R2=0.534,P0.05;各年齡組早期隨機血糖對比,差異具有統(tǒng)計學(xué)意義(F=6.91,P0.05);休克延遲復(fù)蘇組和非休克延遲復(fù)蘇組早期血糖對比,差異有統(tǒng)計學(xué)意義(T=3.58,P0.05);不同程度的吸入性損傷間燒傷早期血糖對比,差異具有統(tǒng)計學(xué)意義(F=24.79,P0.05);不同的燒傷原因間燒傷早期血糖對比,差異具有統(tǒng)計學(xué)意義(F=7.02,P0.05)。但經(jīng)COX回歸分析,顯示只有休克延遲復(fù)蘇、重度吸入性損傷、III度燒傷面積、深I(lǐng)I度燒傷面積四個因素與燒傷早期血糖變化相關(guān)聯(lián),血糖異常組和正常組間對比,住院時間、全身感染發(fā)生率、感染部位數(shù)量、死亡率差異具有統(tǒng)計學(xué)意義(P0.05),血糖異常組住院時間大于正常組,異常組全身感染發(fā)生率高于正常組,異常組感染部位數(shù)量多于正常組,異常組死亡率高于正常組,多器官功能障礙發(fā)生率差異無統(tǒng)計學(xué)意義(X~2=2.064,P0.05)。結(jié)論:(1)燒傷深度、面積、休克延遲復(fù)蘇、重度吸入性損傷四個因素是影響嚴重?zé)齻缙谘亲兓闹饕蛩亍?2)患者性別、年齡以及燒傷原因與嚴重?zé)齻缙谘亲兓療o相關(guān)聯(lián)。(3)早期血糖升高增加燒傷患者死亡率、住院時間、感染發(fā)生率,但對多器官功能障礙發(fā)生率影響較小。
[Abstract]:Objective: to analyze and summarize the changes of early blood glucose in severe burn patients in our department in recent years, and to explore the influencing factors of early blood glucose change and its influence on clinical prognosis in order to provide reference for clinical diagnosis and treatment in the future.Methods: from January 2013 to May 2016, 122 patients with severe and severe burn, including age, sex, delayed resuscitation of shock, cause of burn, area of burn, were collected.Incidence of inhalation injury, early randomized blood sugar, systemic infection, mortality, length of stay, number of sites infected, and incidence of MODS.The T test and other statistical analysis were carried out with SPSS19.0 software.Results: by univariate analysis, there was a linear relationship between burn area and early blood glucose, and the correlation coefficient was R _ (2) 0.534 (P _ (0.05)).The difference was statistically significant (P 0.05), the difference between delayed shock resuscitation group and non-shock delayed resuscitation group was statistically significant.The difference was statistically significant (P 0.05), and the difference was statistically significant among different burn causes (P 0.05).However, COX regression analysis showed that only four factors, such as delayed resuscitation of shock, severe inhalation injury and deep second-degree burn area, were associated with the changes of blood glucose in the early stage of burn. The blood glucose abnormality group and the normal group were compared, and the length of stay was compared.The incidence of systemic infection, the number of infected sites and the mortality rate were significantly different (P 0.05). The duration of hospitalization in abnormal blood glucose group was longer than that in normal group, the incidence of systemic infection in abnormal group was higher than that in normal group, and the number of infected sites in abnormal group was more than that in normal group.The mortality rate in abnormal group was higher than that in normal group, and there was no significant difference in the incidence of multiple organ dysfunction.Conclusion (1) depth of burn, area of burn, delayed resuscitation of shock, severe inhalation injury are the main factors influencing the change of blood glucose in the early stage of severe burn.Age and the cause of burn were not associated with the changes of blood glucose in severe burn. (3) the increase of early blood glucose increased the mortality, hospital stay and infection rate of burn patients, but had little effect on the incidence of multiple organ dysfunction.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R644

【參考文獻】

相關(guān)期刊論文 前10條

1 楊小東;翁孝剛;;危重患者高血糖反應(yīng)與炎癥細胞因子及預(yù)后的相關(guān)性研究[J];中國現(xiàn)代藥物應(yīng)用;2016年02期

2 李雪佳;韓立坤;;應(yīng)激性高血糖研究進展[J];內(nèi)蒙古民族大學(xué)學(xué)報(自然科學(xué)版);2015年02期

3 李剛;鮑歡;郝俊杰;左聯(lián);肖亞平;楊玉梅;王悅;胡暉;黃東雅;王少石;;急性缺血性卒中患者的早期診療指南——美國心臟協(xié)會/美國卒中協(xié)會為醫(yī)療保健專業(yè)人員制定的指南(第七部分)[J];中國卒中雜志;2013年11期

4 李大偉;申傳安;柴家科;馬麗;尚玉茹;李龍珠;;嚴重燙傷大鼠胰島β細胞結(jié)構(gòu)和功能的變化[J];中華燒傷雜志;2013年04期

5 程思;鄧忠良;;創(chuàng)傷后應(yīng)激性高血糖的診治進展[J];重慶醫(yī)學(xué);2012年33期

6 賈春梅;李春學(xué);崔瑩;李勇;吳春雪;郭晉平;宋亞琦;;應(yīng)激性高血糖發(fā)病機制[J];河北醫(yī)藥;2011年12期

7 李庚;卞茸文;歐陽曉俊;婁青林;顧劉寶;;正常糖耐量人群年齡與胰島功能關(guān)系的研究[J];實用老年醫(yī)學(xué);2010年06期

8 于健春;;危重患者高血糖的控制[J];中華普通外科學(xué)文獻(電子版);2009年05期

9 杜彥蓉;閔連秋;;急性腦梗死患者應(yīng)激性高血糖與近期預(yù)后的關(guān)系[J];遼寧醫(yī)學(xué)院學(xué)報;2007年04期

10 胡興國 ,張云翔 ,曾因明;危重病人應(yīng)激性高血糖的研究進展[J];國外醫(yī)學(xué).麻醉學(xué)與復(fù)蘇分冊;2005年03期

，

本文編號：1750360