Savić J, Cernak I, Jevtić M, Todorić M
Military Medical Academy, Institute for Medical Research, Clinic for General and Vascular Surgery and Clinic for Thoracic and Cardial Surgery, Beograd, Yugoslavia.
J Trauma. 1996 Mar;40(3 Suppl):S144-7. doi: 10.1097/00005373-199603001-00031.
The plasma concentrations of glucose, adrenaline, noradrenaline, insulin, and cortisol were measured in 59 patients within 18 hours of military gunshot/missile (MG/M) wound. The wounds were categorized by the Red Cross Wound Classification (RCWC) and assessed by the Injury Severity Score (ISS) method. The majority of the measured biochemical parameters, except insulin, were significantly increased after MG/M wounds, compared with control values. Plasma glucose concentration in wounded patients was positively related to ISS over the whole severity range. Plasma insulin concentration increased with glucose. Noradrenaline and cortisol were positively related to glucose. Because hemorrhage is the most common cause of general response to MG/M wound, we concluded that glucose measurement could be a useful adjunct tool to the RCWC in rapid and accurate assessment of severely wounded patients, especially those with occult thoraco-abdominal wounds.
在59例军事枪伤/导弹伤（MG/M）患者受伤后18小时内，测定了其血浆葡萄糖、肾上腺素、去甲肾上腺素、胰岛素和皮质醇的浓度。伤口按照红十字伤口分类法（RCWC）进行分类，并采用损伤严重度评分（ISS）方法进行评估。与对照值相比，除胰岛素外，大多数测定的生化参数在MG/M伤后显著升高。在整个严重程度范围内，受伤患者的血浆葡萄糖浓度与ISS呈正相关。血浆胰岛素浓度随葡萄糖升高而增加。去甲肾上腺素和皮质醇与葡萄糖呈正相关。由于出血是对MG/M伤产生全身反应的最常见原因，我们得出结论，在快速准确评估重伤患者，尤其是那些有隐匿性胸腹伤的患者时，葡萄糖测定可能是RCWC的一种有用辅助工具。
