论文部分内容阅读
目的探讨胰岛素对脑出血急性期的治疗效果、剂量效应以及胰岛素的作用机制。方法将130例原发脑出血病例随机分为对照组、治疗Ⅰ组和治疗Ⅱ组,治疗Ⅰ组和治疗Ⅱ组在对照组的常规治疗基础上分别在静滴液中加入16U、20U胰岛素,治疗14d后分析三组水肿体积、血肿体积、神经功能缺损评分以及血糖的变化。结果治疗14d后,两组治疗组脑血肿体积、水肿体积、神经功能缺损评分减少以及治愈率均较对照组显著(P<0.05),但两治疗组之间的对比差异无显著性(P>0.05);治疗Ⅱ组第14天血糖较对照组降低(P<0.05),且5例出现低血糖;治疗组死亡率均较对照组下降,但无统计学意义。结论脑出血急性期应用小剂量胰岛素(16U)能够促进血肿吸收、显著减轻水肿体积、减轻神经功能缺损,提高剂量不但不能提高疗效,且易诱发低血糖倾向。
Objective To investigate the therapeutic effect of insulin on acute cerebral hemorrhage, the dose effect and the mechanism of action of insulin. Methods 130 cases of primary intracerebral hemorrhage were randomly divided into control group, treatment group Ⅰ and treatment group Ⅱ. The treatment group Ⅰ and the treatment group Ⅱ were given 16U and 20U insulin respectively in the intravenous drip on the basis of routine treatment of the control group, After 14 days of treatment, the changes of edema volume, hematoma volume, neurological deficit score and blood glucose were analyzed. Results After 14 days of treatment, the volume of cerebral hematoma, the volume of edema, the decrease of neurological deficit score and the cure rate in the two treatment groups were significantly higher than those in the control group (P <0.05), but there was no significant difference between the two treatment groups (P> 0.05). On the 14th day after treatment, the blood glucose in group Ⅱ was lower than that in control group (P <0.05), and hypoglycemia was found in 5 cases. The mortality of treatment group was lower than that of control group, but there was no statistical significance. Conclusions The acute administration of low dose of insulin (16U) can promote the absorption of hematoma, reduce the volume of edema and reduce the neurological deficit significantly. Increasing dosage not only can not improve the curative effect, but also tends to induce hypoglycemia.