神经外科高渗高血糖非酮症性昏迷的临床研究  

Clinical study of the hyperglycemic hyperosmolar nonketotic coma after head injury and craniotomy

作　　者：赵经郊[1] 孙敬照 黄崇熙[1] 唐祖是 刘洋[1] 张兵[1] 孙森[1] 

机构地区：[1]青岛市市立医院神经外科

出　　处：《中华神经外科杂志》1995年第6期338-340,共3页Chinese Journal of Neurosurgery

摘　　要：对１２例高渗高血糖非酮症性昏迷（ＨＨＮＣ）病人进行临床研究，认为神经外科病人并发ＨＨＮＣ，主要是丘脑下部损害和较长时间大量脱水剂使用引起的，不同于糖尿病引起的高渗性非酮症性糖尿病昏迷（ＨＮＤＣ）。根据血糖、血清钠增高情况分为高糖型、高钠型、高糖高钠型和普通型四种临床类型，提出在中心静脉压（ＣＶＰ）监测下按上述分型确定合理的治疗计划，取得了较好的疗效。８例病人纠正了高渗状态。已有５例痊愈出院。并对诊断、治疗和预防等有关问题进行了研究。Abstract Hyperglycemic hyperosmolar nonketotic coma(HHNC)after craniocerebral injury and craniotomy is not uncommon. Which manifests dehydration and psychoneurotic symptoms in the early stage and shock and coma in the late stage.High mortality rate was due to misdiagnosis and unsuitable treatment.Among the totally 12 cases treated in our department 8 cases were succussfully treated 5of them were recovered and discharged. From this study we suggest:(1) HHNC are caused by injury of hypothalamus and long term by using of dehydrant;(2) According to the blood concentrations of glucose and natrium for treatment and prognosis we proposed four types:hyperglycemic, hypernatremic, hyperosmolar and common type;(3) CVP monitoring for volume of fluid infusion.The therapeutic effectiveness would be highly promoted.

关 键 词：高渗性 高血糖性 非酮症性 昏迷 神经外科 

分 类 号：R651[医药卫生—外科学] R741.041[医药卫生—临床医学]