重型颅脑损伤并发非酮高渗综合征42例报告

Report of 42 nonketotic hyperosmolar syndrome patients complicated by severe head injury

目的探讨重型颅脑损伤并发非酮高渗综合征的发病机制,临床特点及救治措施。方法对2000年5月!2004年10月间收治的42例重型颅脑损伤并发非酮高渗综合征病人的临床资料作回顾性分析。结果所有病人均以严重脱水,意识障碍加深为主要临床表现,血糖及血钠均明显升高,血浆渗透压#350mOsm/L。所有病人经确诊后予补液纠正脱水,应用胰岛素,补钾及防治并发症等综合治疗。本组死亡24例,重残植物生存12例,恢复良好6例。结论重型颅脑损伤病人并发非酮高渗综合征,预后不佳,早期诊治有助于改善预后。

[Objective] To explore the pathogenesis, clinical features and treatment of nonketotic hyperosmolar syndrome（NHS） complicated by severe head injury （SHI）. [Methods] The clinieal information of 42 NHS patients complicated by SHI from May 2000 to October 2004 were reviewed. [Results] The principal clinical performances of all patients were severe dehydration and aggravating disturbances of eonsciousness. Their blood sugar and natrium rose obviously, plasma osmotic pressure〉350mOsm/L All cases were treated by transfusion and insulin.24 eases were dead,12 cases were badly disabled or vegetative state and 6 cases recovered in this group. [Conclusions] The prognosis of NHS complicated by SHI is worse. The earlier the diagnosis and treatment, the better the prognosis.