高渗性非酮症性糖尿病昏迷若干临床问题探讨(附12例临床分析)

Clinical Analysis of Hyperosmolar Nonketotic Diabetic Coma

本文对12例高渗性非酮症性糖尿病昏迷者进行了回顾性分析。11例有明确发病诱因，包括感染、进甜食、用药不当等。仅7例发病前有糖尿病史。所有病人均出现意识障碍并伴脱水征象。全部病例血渗透压＞330mOsm／L。病死率为41．7％。重点探讨了该病的早期诊断要点和及时纠正高渗状态的重要性，分析了影响该病预后的多种因素，提出在针对高渗高糖的同时，积极处理各种并发症和伴随症对预后具有同等的重要性。

Twelve cases of hyperosmolar nonketotic coma patients were studied. Eleven patients presented with precipitating factors including infection, intake of sweet food, infusion of hype rsmolar solutin and so on. Only 7 cases had a history of diabetes. In all cases, the effective serum osmolarity was higher than 330 mosrn /L. The fasting blood sugar levels were higher than 33. 3 mmol/L in 58. 3 % of the cases (7/12) The mortality rate was 41. 7 % (5/12). The main points of early diagnosis, the importance of prompt correction of hyperosmolar state and key factors of reducing mortality rsate were discussed.