中文摘要：

目的：探讨不同血糖控制目标对腹部术后重症应激性高血糖影响。方法选择开腹部术后发生应激性高血糖患者76例，随机分为A组和B组，每组38例，A组和B组分别以（7.8-10.0）mmol/L和（4.5-8.3）mmol/L作为血糖控制目标，采用相同胰岛素干预方案，对比两组血糖达标时间、生化指标、血糖控制不良反应、并发症、住院时间。结果 A组和B组血糖控制达标时间比较，差异有统计学意义（P〈0.05），A组在术后72 h内血糖均逐渐降至正常范围内，A组降钙素原和C反应蛋白值显著低于B组（P〈0.05），两组均未发生高渗性昏迷，A组低血糖和严重低血糖发生率显著低于B组（P〈0.05），两组均无死亡病例，两组切口感染、腹腔感染、肺部感染、败血症及住院时间比较，差异均无统计学意义（P〉0.05）。结论腹部手术后应激性高血糖患者血糖控制在（7.8-10.0）mmol/L范围更有利于减轻患者术后机体免疫系统应激反应，降低低血糖发生率，并不增加术后感染发生，具有良好的术后获益和安全性。

英文摘要：

Objective To explore the different stress hyperglycemia blood sugar control target of the impact of severe abdominal surgery. Methods Chose open abdominal postoperative stress hyperglycemia 76 patients were randomly di-vided into group A and group B, each of 38 cases, A and B, respectively, to 7.8-10.0 mmol/L or 5.6-8.3 mmol/L as glycemic control targets, used the same insulin intervention programs, compared two groups of blood glucose time,biochemical parameters, glycemic control adverse reactions, complications, length of hospital stay. Results A group and B group blood sugar control standard time,the differences were statistically significant （P〈0.05）, A group within 72h after surgery were gradually reduced blood sugar within normal range, A group of procalcitonin and C-reactive protein values were significantly lower than group B （P〈0.05）, the two groups did not occur hyperosmolar coma , A group of hypoglycemia and severe hypoglycemia were significantly lower than group B （P〈0.05）, were no deaths ,wound infection, abdominal infections, lung infections, sepsis, incidence of death and hospitalization time , the dif-ferences were not statistically significant（P〉0.05）. Conclusion Abdominal surgery in patients with stress hyperglycemia blood sugar control in 6.0-10.0 mmol/L range were more conducive to the body＇s immune system to reduce postopera-tive stress response, reduce the incidence of hypoglycemia, does not increase postoperative infection, with good post-operative benefit and safety.