| 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年1月-2016年12月在我院接受治疗的急性脑卒中并发高渗性非酮症糖尿病昏迷患者92例，均经由急诊收治入院，分析治疗效果。结果：92例中主要发病因素为呼吸系统感染，其次为尿路感染及胃肠道感染；所有患者苏醒时间为（21.206.82）h，渗透压恢复正常时间（32.6911.52）h、休克纠正时间（12.825.63）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，差异显著（<0.05）；发生并发症22例（脑水肿8例，心力衰竭7例，呼吸衰竭5例，多器官系统衰竭2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。 |
| 关键词: 急性脑卒中 高渗性非酮症糖尿病 昏迷 |
| DOI：0 |
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| Acute stroke patients with hyperosmolar non ketotic diabetic coma in the emergency diagnosis and treatment analysis |
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| Abstract: |
| Objective: To analyze the acute stroke of hyperosmolar nonketotic diabetic coma in emergency treatment. Methods: From January 2014 to December 2016 in our hospital treatment of 92 cases of acute cerebral stroke complicated with hyperosmolar non ketotic diabetic coma patients, patients were admitted through the emergency treatment, analysis. Results: The major risk factors in 92 cases of respiratory infection, followed by urinary tract infection and gastrointestinal tract infection; all the patients recovery time was (21.206.82) h, osmotic pressure recovery time (32.6911.52), H (12.825.63) h time to correct shock; 92 cases of patients with blood glucose, serum sodium, serum potassium, blood hormone nitrogen and plasma colloid osmotic pressure after treatment were significantly better than before treatment, the difference was significant (<0.05); 22 cases of complications (8 cases, 7 cases of cerebral edema, 5 cases of heart failure, respiratory failure and multiple organ system failure in 2 cases, 18 cases died (19.57%), failure to rescue 13 cases, a total of 5 cases) misdiagnosis, 27 cases (29.35%). Conclusion: Acute stroke patients with hyperosmolar nonketotic diabetic coma death risk is very high, so early detection, accurate diagnosis, rapid assessment of the disease, correct water and electrolyte disorders as soon as possible, and actively improve the clinical manifestations in predisposing factors, improve the success rate of rescue |
| Key words: Acute stroke Hyperosmolar nonketotic diabetic, Coma |
