糖尿病非酮症高渗性昏迷患者的临床急救措施及治疗效果分析  

Clinical First Aid Measures and Treatment Effect Analysis of Patients with Diabetic Nonketotic Hyperosmolar Coma

作　　者：蓝晓莲[1] 张玉雄 阙国文 LAN Xiaolian;ZHANG Yuxiong;QUE Guowen(Outpatient Department of the First Hospital of Longyan City,Longyan,Fujian Province,364000 China;Emergency Department of the First Hospital of Longyan City,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第一医院门诊部,福建龙岩364000 [2]福建省龙岩市第一医院急诊部,福建龙岩364000

出　　处：《糖尿病新世界》2022年第1期165-168,共4页Diabetes New World Magazine

摘　　要：目的探讨糖尿病非酮症高渗性昏迷患者的临床急救措施及治疗效果。方法回顾性分析2020年1月—2021年1月该院收治的60例糖尿病非酮症高渗性昏迷患者的临床资料,全部患者均接受临床急救治疗,包括根据患者自身的渗透压、失水量与血糖水平,为其开展静脉输液治疗,采用小剂量胰岛素静脉缓滴,并通过静脉输液缓慢补液,总结急救治疗效果。结果该组患者治疗后有效59例,无效1例,治疗有效率为98.33%。该组患者的苏醒时间为(16.85±3.65)h,渗透压恢复正常时间为(31.25±8.54)h,休克纠正时间为(11.25±3.62)h。该组患者治疗后血糖、血钠、血浆渗透压与血尿素氮水平均低于治疗前,血钾水平高于治疗前,差异有统计学意义(P<0.05);该组患者发生水肿4例,心衰1例,并发症发生率为8.33%。结论及时为糖尿病非酮症高渗性昏迷患者开展静脉输液,使其体内渗透压得到调整,并补充水分,小剂量应用胰岛素静脉滴注,可获取良好的治疗效果。Objective To explore the clinical first aid measures and treatment effects of diabetic nonketotic hyperosmolar coma patients. Methods The clinical data of 60 patients with diabetic nonketotic hyperosmolar coma admitted to the hospital from January 2020 to January 2021 were retrospectively analyzed. All patients received clinical emergency treatment. Including the patient’s own osmotic pressure, water loss and blood glucose level, to carry out intravenous infusion therapy for the patient, using small doses of insulin intravenous slow drip. And slowly replenish fluid through intravenous infusion to summarize the effect of emergency treatment. Results After treatment,59 patients in this group were effective and 1 was ineffective. The effective rate of treatment was 98.33%. The recovery time of the patients in this group was(16.85±3.65) h, the time for osmotic pressure to return to normal was(31.25 ±8.54) h, and the shock correction time was(11.25 ±3.62) h. After treatment, blood glucose, blood sodium,plasma osmolality and blood urea nitrogen levels in this group of patients were lower than before treatment, and blood potassium levels were higher than before treatment, the difference was statistically significant(P<0.05). 4 cases of edema and 1 case of heart failure occurred in this group of patients. The complication rate was 8.33%.Conclusion Timely carry out intravenous infusion for patients with diabetic nonketotic hyperosmolar coma to adjust their osmotic pressure. In addition, water is added, and a small dose of insulin is administered intravenously to obtain a good therapeutic effect.

关 键 词：糖尿病 非酮症高渗性昏迷 临床急救措施 血糖 渗透压 并发症 

分 类 号：R587.2[医药卫生—内分泌]