Effect of intensive insulin therapy on cerebrospinal fluid lactic acid metabolism in patients with severe head injury
- VernacularTitle:胰岛素强化治疗对急性重型颅脑损伤患者脑脊液乳酸代谢的影响
- Author:
Xiaodong ZHAO
- Publication Type:Journal Article
- Keywords:
acute severe brain injury;
intensive insulin therapy;
prognosis
- From:Journal of Third Military Medical University
1988;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate whether the strict control of serum glucose can improve the prognosis for cerebral metabolism and nervous system of these patients with severe head injury.Methods A total of 46 severe head injury patients were randomly assigned to receive intensive insulin therapy or routine therapy,titrating serum glucose levels at 4-6 mmol/L and less than 11 mmol/L respectively.All patients were treated according to neurosurgical intensive care routine including monitoring intracranial pressure(ICP).Lactate and pH value of cerebrospinal fluid(CSF) were tested continually in a week after admission,while Glasgow Coma Scale(GCS) scores were appealed for evaluating neurological function in the two groups.Results In comparison with control group,lactate concentrations and intracranial pressure significantly decreased after insulin treatment as well as the marked elevation of GCS scores.There was no difference in pH values of CSF between the two groups.Intensive insulin therapy also reduced the ICU days and hospital stay.Conclusion As a valuable protocol for glucose management,intensive insulin therapy ameliorates the accumulation of lactate in the ischemic brain tissue after injury,depress ICP during oedema cresttime and improve neurological outcomes.
