摘要
目的分析急性脑卒中并发高渗性非酮症糖尿病昏迷急诊诊治效果。方法选择2014-01—2016-12间在息县人民医院接受治疗的92例急性脑卒中并发高渗性非酮症糖尿病昏迷患者,均经由急诊收治入院,分析治疗效果。结果 92例患者主要发病因素为呼吸系统感染,其次为尿路感染及消化系统炎症;所有患者苏醒时间(21.20±6.82)h,渗透压恢复正常时间(32.69±11.52)h、休克纠正时间(12.82±5.63)h;92例患者血糖、血钠、血钾、血素氮以及血浆胶体渗透压治疗后均明显好转,优于治疗前,差异有统计学意义(P<0.05);发生并发症22例,死亡18例(19.57%),抢救失败13例,放弃5例),初诊误诊27例(29.35%)。结论急性脑卒中并发高渗性非酮症糖尿病昏迷死亡风险非常高,因此需尽早发现,准确诊断,迅速评估病情,尽快纠正其水电解质紊乱情况,针对诱发因素积极改善临床表现,提高抢救成功率。
Objective To analyze the acute stroke of hyperosmolar nonketotic diabetic coma in emergency diagnosis and treatment.Methods 92 cases of acute cerebral stroke complicated with hyperosmolar non ketotic diabetic coma patients from January,2014 to December,2016 in the hospital were selected.Patients were admitted through the Emergency.Treatment effect was analyzed.Results The major risk factors in 92 cases are respiratory infection,followed by urinary tract infection and gastrointestinal tract infection.Recovery time of all patients is（21.20 ± 6.82） h,osmotic pressure recovery time is（32.69 ± 11.52） h,and shock correcting time is（12.82 ± 5.63） h.Blood glucose,serum sodium,serum potassium,blood hormone nitrogen and plasma colloid osmotic pressure of 92 patients are significantly better than before treatment,and the difference is significant（P 0.05）; 22 cases have complications,18 cases die（19.57%,13 failure to rescue cases and 5 abandon cases）,27 cases have misdiagnosis（29.35%）.Conclusion Acute stroke patients with hyperosmolar nonketotic diabetic coma has high risk of death.So early detection,accurate diagnosis,rapid assessment,correcting water and electrolyte disorders as soon as possible,and actively improving the clinical manifestations in predisposing factors can improve the success rate of rescue.
出处
《黑龙江医学》
2017年第12期1168-1170,共3页
Heilongjiang Medical Journal
