静脉补液结合消化道补水治疗高渗高血糖状态的疗效观察

Effect of intravenous fluid infusion combined with water throuth gastrointestinal tract on treatment of patients with hyperosmolar hyperglycemic state

目的探讨静脉补液结合消化道补水在治疗高渗高血糖状态(HHS)中的作用。方法33例HHS患者纳入本研究。在静脉补液的同时,匀速进行消化道补水,观察治疗前后血钠、血钾、血糖、有效血浆渗透压等变化及补液、补钾量和预后。结果经静脉补液和消化道补水,血糖、有效血浆渗透压平稳下降,治疗头12h血糖及有效血浆渗透压下降速度不超过3mmol·L^(-1)·h^(-1);治疗48h后,除2例死亡外,其余患者血钠、血钾和血浆渗透压恢复正常,血糖为(10.8±5.2)mmol/L。结论静脉补液结合消化道补水能平稳降低血糖、有效血浆渗透压,降低HHS病死率。

Objective To investigate the effect of intravenous fluid infusion combined with water throuth gastrointestinal tract in treating the patients with hyperosmolar hyperglycemic state（HHS）. Methods 30 HHS patients were recruited. All the patients were given water throuth gastrointestinal infusion while they were administrated continuously intravenous infusion. Laboratory parameters such as serum natrium, serum potasium, serum glucose and serum osmolarity ect were monitored at the admission and after treatment. Results Serum glucose and serum osmolarity of HHS patients were decreased smoothly at the speed of less than 3 mmol·L^-1·h^-1 during the first 12 hours after treatment. After 48 hour-treatment,serum natrium,serum potassium and serum osmolarity recovered to normal levels except 2 deaths,serum glucose decreased to （10.8 ± 5.2）mmol/L. Conclusion Intravenous fluid infusion combined with water throuth gastrointestinal tract for the patients could lower smoothly serum glucose and serum osmolarity and decrease the mortality of the HHS patients.