危重儿血糖监测及临床分析.docVIP

危重儿血糖监测及临床分析 　【关键词】 危重儿 　　［摘 要］ 目的：分析危重儿血糖与危重程度及预后的关系，评价危重儿血糖监测的临床意义。方法：对50例危重儿（不含极危重儿）、28例极危重儿和30例非危重患儿进行血糖监测，并进行对比观察和分析。结果：危重儿组、极危重儿组血糖异常发生率显著高于非危重儿组；极危重儿组血糖异常发生率显著高于危重儿组。血糖异常以高血糖为主。高血糖越显著，持续时间越长，且难纠正者，预后差。结论：危重病儿高血糖水平与病情的严重程度及预后显著相关，对危重儿应密切监测血糖变化，及早发现和尽快纠正高血糖或低血糖,改善预后。 　　［关键词］ 危重儿；极危重儿；低血糖；高血糖 　　Blood Glucose Monitoring and its Clinical Studyin Criticaldiseased Children 　　Abstract：Objective To study the relation between the changes of blood glucose and critical situationas well as prognosis,to evaluate the clinical significance of the glucose measurement.Methods To monitor the variety of blood glucose in 50 critical diseased children,28 very critical diseased children and 30 noncritical diseased children,to compare,observe and analysis it.Results The blood glucose abnormity is significantly higher in the critical diseased children and the very critical diseased children comparing to the noncritical diseased children（χ2＝40.80）；the blood glucose abnormity is significantly higher in the very critical diseased children comparing to the critical diseased children（χ2＝27.74）.Most blood glucose abnormity was hyperglycemia.Conclusion The blood glucose level of critical diseased children is closely related to the critical situation and its prognosis,blood glucose monitoring should be frequently,hypoglycemia and hyperglycemia should be checked and corrected as early as possible,then prognosis would be better. 　　Key words：Critical diseased children;Very critical diseased children;Hypoglycemia;Hyperglycemia 危重儿机体遭受致病因子刺激后，可引起十分复杂的应激反应，出现内分泌紊乱、糖代谢异常。本文观察了1999年1月至2005年6月我院收治的50例危重儿及28例极危重儿急性期的血糖变化，并分析其与疾病严重程度及预后的关系，现报告如下。 　　1 对象与方法 　　1.1 对象 　　按照小儿危重病例评分法［1］：70～80分为危重儿组（不含极危重儿），lt;70分为极危重儿组，gt;80分为非危重儿组。本文患儿年龄在28 d～11岁3月，危重儿组50例，男27例，女23例；极危重儿组28例，男15例，女13例；原发病：重症肺炎34例，颅内出血6例，颅内感染16例，败血症及感染性休克8例，重度营养不良2例，急性中毒4例，溺水2例，失血并休克3例，阵发性室上性心动过速并心力衰竭2例，肠坏死切除术后1例。非危重儿组30例，男17例，女13例，原发病：肺炎18例，急性腹泻病12例。两组病例均无糖尿病病史及家族史，其性别构成、年龄均差异无显著性。 　　1.2 方法 　　1.2.1 所有患儿入院时输液前即抽静脉血，葡萄糖氧化酶法测定血糖；并根据病情定时用ONE