ICU患者血糖的控制精品课件.ppt

2021/4/26 必威体育精装版 PPT 欢迎下载 * 死亡率和生存时间 Ninety days after randomization, 829 of 3010 patients (27.5%) in the intensive-control group had died, as compared with 751 of 3012 patients (24.9%) in the conventional-control group 随机分组后90天， 强化胰岛素治疗组3010例中的829例（ 27.5 ％ ）死亡，而传统治疗组3012例中的751例（ 24.9 ％ ）死亡 The median survival time was lower in the intensive-control group than in the conventional-control group 平均生存时间强化胰岛素治疗组低于传统治疗组 2021/4/26 必威体育精装版 PPT 欢迎下载 * 90天存活率 The probability of survival, which at 90 days was greater in the conventional-control group than in the intensive-control group (hazard ratio, 1.11; 95% confidence interval, 1.01 to 1.23; P = 0.03). 90天存活率强化胰岛素组高于传统治疗组 2021/4/26 必威体育精装版 PPT 欢迎下载 * ICU留住时间 During the 90-day study period, there was no significant difference between the two groups in the median length of stay in the ICU 在90天的研究期间，2组ICU平均留住时间没有显著差异 2021/4/26 必威体育精装版 PPT 欢迎下载 * 器官功能衰竭，机械通气时间和肾脏替代疗法 The number of patients in whom new single or multiple organ failures developed were similar with intensive and conventional glucose control (P = 0.11) 新发生的单个或多器官功能衰竭，2组相似 There was no significant difference between the two groups in the numbers of days of mechanical ventilation and renal replacement therapy 机械通气时间和肾脏替代疗法没有显著差异 2021/4/26 必威体育精装版 PPT 欢迎下载 * 2021/4/26 必威体育精装版 PPT 欢迎下载 * subgroup analyses With respect to 90-day mortality, subgroup analyses suggested no significant difference 90天死亡率亚组间没有显著差异 亚组死亡率 P值 手术/非手术 0.1 糖尿病 0.6 Severe sepsis 0.93 外伤 0.07 使用皮质激素 0.06 90天死亡率 0.02 2021/4/26 必威体育精装版 PPT 欢迎下载 * 最佳目标血糖水平 In this large, international, randomized trial, we found that intensive glucose control increased mortality among adults in the ICU: a blood glucose target of 180 mg(10.0 mmol or less per liter) or less per deciliter resulted in lower mortality than did a target of 81 to 108 mg per deciliter(4.5 to 6.0 mmol per liter). 这次大样本国际随机实验显示：在ICU患者强化胰岛素治疗增加死亡率，与4.5-6mmol/dl的目标血糖水平相比 ，10mmol/dl及以下的血糖水平能降低死亡率 On the basis of our results, we do not recommend use