胃肠内补液救治高渗性非酮症糖尿病昏迷的临床研究  

Clinical value of gastroenteric fluid replacement for hyperosmolar nonketotic diabetic coma

作　　者：李伟[1] 张红[1] 殷松楼[1] 张振 孔繁沛 

机构地区：[1]徐州医学院附属医院内分泌科,江苏徐州221002 [2]徐州市第六人民医院内分泌科,江苏徐州221006 [3]沛县人民医院内分泌科,江苏沛县221600

出　　处：《徐州医学院学报》2006年第2期146-149,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨胃肠内补液救治高渗性非酮症糖尿病昏迷(HNDC)的临床疗效。方法32例HNDC患者,18例采用胃肠内补液联合静脉补液方法治疗(胃肠内补液组),14例采用常规静脉补液方法治疗(常规治疗组),观察2组患者治疗前和治疗后6、244、8 h血生化指标及血浆渗透压的变化,观察病情变化、并发症和病死率。结果胃肠内补液治疗后62、4、48 h血糖、血钠、血钾、血尿素氮、血浆渗透压较快恢复正常,患者清醒早、补液量少,有效降低了心力衰竭、脑水肿的发生和病死率。结论胃肠内补液救治HNDC疗效优于传统的静脉补液治疗,且简单易行、安全高效。Objective To investigate the clinical value of gastrcenteric fluid replacement for hyperosmolar nonketotie diabetic coma （HNDC）. Methods Thirty- two patients with HNDC were randomly divided into two groups to undergo combined gastrcenterie and venous fluid replacement （gastroentefic fluid group, n = 18） and common venous fluid replacement （common treatment group, n = 14）. The changes in their blood biochemical indexes and plasma crystal osmotic pressure were noticed before and 3 and 24 h after the treatment, along with the patients＇ condition, complication and mortality. Results 6 h, 24 h and 48h after combined venous and gastroentefie fluid replacement, the levels of blood glucose, sodium and potassium, urea nitrogen and plasma crystal osmotic pressure, all were improved quickly. The therapy significantly reduced the mortality and the morbidity of heart failure and cerebral edema, with the patients waking up earlier and less fluid eousumed. There appeared significant differences in effects between the two therapies （ P 〈 0.05）. Conclusion The efficacy of combined gastroentefie fluid replacement for HNDC is notably better than the traditional venous fluid replacement, besides its simplicity, feasibility and safety.

关 键 词：胃肠内补液 糖尿病 高渗性非酮症昏迷 血浆渗透压 

分 类 号：R587.2[医药卫生—内分泌]