中文摘要：

目的 探讨胰岛素强化治疗对严重创伤患者预后的影响，研究其对危重患者脏器的保护作用。方法 选择64例严重创伤患者，分为胰岛素强化治疗组和对照组，分别给予胰岛素强化治疗和常规治疗，在入院后0、2、4、6、8d留取外周静脉血，同时每日行APACHEⅡ评分，并记录反映脏器功能的生化指标和预后主要指标。结果 胰岛素强化治疗实施的安全性良好。强化治疗严格控制血糖后，心功能、肝功能、肾功能不全发生率显著下降，APACHEⅡ评分降低，两组患者死亡率、院内感染发生率比较差异具有统计学意义。结论 胰岛素强化治疗能有效降低ICU中危重患者脏器功能不全等并发症的发生，既降低死亡率，又减少感染出现。

英文摘要：

Objective To study the effect of early intensive insulin therapy on the prognosis of severe trauma patients. Methods 64 severe trauma patients （ISS 〉 20, blood glucose levels were controlled within the range 6 - 8 mmol/L} were randomly divided into intensive insulin therapy group and control group, which were given intensive and routine insulin respectively. Blood samples were obtained at 0, 2, 4, 6 and 8 day after admission to hospital. APACHE Ⅱ score was counted continually, and biological parameters of organ function and main prognostic indexes were recorded. Results The safety of intensive insulin therapy was better. After blood sugar was controlled strictly by intensive therapy, the incidences of acute renal, heart and liver failure reduced obviously. APACHE Ⅱ score decreased. There were obvious differences in mortality and the incidence of nosocomial infection. Conclusion In comparison with control group, intensive insulin therapy can protect organ functions of injured patients in ICU and reduce infection incidence and mortality of organ function failure patients.