Wang Yan, Li Jin-Ping, Song Ying-Lun, Zhao Qi-Huang
Department of Neurosurgery (Intensive Care Unit) Department of Neurosurgery, Beijing ChaoYang Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2017 Mar;96(13):e6458. doi: 10.1097/MD.0000000000006458.
To assess the effect of intensive insulin therapy (IIT) for preventing postoperative infection in patients with traumatic brain injury (TBI).
In total, 88 patients with TBI were randomly divided into 2 groups, 44 in each group. One group (group ITT) received IIT and the other group (group CIT) received conventional insulin therapy (CIT). This study was conducted between February 2013 and January 2016. Outcomes included infection rate, mortality, and neurological outcome (measured by the Glasgow Outcome Scale [GOS]).
A total of 81 patients completed the study. IIT showed greater efficacy than CIT, with a decreased infection rate in the IIT group compared to the CIT group (31.9% vs 52.3%, P = 0.03), and also a reduced duration of stay in intensive care unit (ICU) (IIT group, 4.5 ± 2.1 days vs CIT group, 5.7 ± 2.8 days, P = 0.02). In addition, a significant difference in scores on the GOS scale was observed between the 2 groups (P = 0.04). The mortality rates in hospital and at the 26-week follow-up were similar between the 2 groups.
IIT leads to a reduced infection rate, shorter stays in ICU, and improved neurological outcome.
评估强化胰岛素治疗（IIT）对预防创伤性脑损伤（TBI）患者术后感染的效果。
总共88例TBI患者被随机分为2组，每组44例。一组（ITT组）接受IIT，另一组（CIT组）接受常规胰岛素治疗（CIT）。本研究于2013年2月至2016年1月进行。观察指标包括感染率、死亡率和神经功能转归（采用格拉斯哥预后量表[GOS]进行评估）。
共有81例患者完成研究。IIT显示出比CIT更好的疗效，IIT组的感染率低于CIT组（31.9%对52.3%，P = 0.03），且重症监护病房（ICU）住院时间也缩短（IIT组，4.5±2.1天对CIT组，5.7±2.8天，P = 0.02）。此外，两组在GOS量表评分上存在显著差异（P = 0.04）。两组的院内死亡率和26周随访时的死亡率相似。
IIT可降低感染率，缩短ICU住院时间，并改善神经功能转归。
