老年低血糖昏迷患者误诊为脑梗死21例临床分析

Clinical analysis in 21 elderly cases with hypoglycemia misdiagnosed as cerebral infarction

目的总结老年低血糖昏迷误诊为脑梗死的原因,探讨防范误诊的方法。方法对我院21例老年低血糖昏迷误诊为脑梗死患者的病史资料进行回顾性分析。结果 21例患者以急性脑梗死收住,确诊为低血糖昏迷后经治疗后意识均转清醒,肢体瘫痪恢复,病理征转阴。结论对老年糖尿病患者有神经症状者,临床医生的诊断不要仅局限于脑血管意外,鉴别诊断应考虑低血糖昏迷,常规查血糖,并详细询问病史,仔细查体,以减少误诊。

Objective To study the reason of elderly hypoglycemia misdiagnosed as cerebral infarction and to explore the way of preventing misdiagnosis.Methods The clinical date of 21 patients with diagnosis of hypoglycemia be misdiagnosed as cerebral infarction were reviewed retrospectively.Results 21 patients misdiagnosed as acute cerebral infarction were diagnosed with hypoglycemia finally and sober awareness of all,the restoration of paralyzed limbs,pathological levy negative after treatment.Conclusion Elderly diabetic patients have neurological symptoms,the diagnosis are not only confined to the cerebral vascular accident,should be consider the differential diagnosis of hypoglycemia,the convention to examation of the blood sugar,and the detailed inquiry medical history,the careful physical examination could reduces misdiagnosis.