非糖尿病低血糖昏迷合并吸入性肺炎10例临床分析

Clinical analysis of ten cases with non-diabetic hypoglycemic coma complicated with aspiration pneumonia

目的探讨非糖尿病低血糖昏迷合并吸入性肺炎的临床特点、诊疗及预后。方法对收治的10例非糖尿病低血糖昏迷合并吸入性肺炎患者进行回顾性分析,了解其临床特征。结果 10例低血糖昏迷病因中酒精中毒4例,肝硬化2例,倾倒综合征1例,慢性肾功能衰竭1例,误服降糖药物1例,膀胱癌1例;患者急诊随机血糖测得中位值1.3 mmol/L;所有患者昏迷后2 d内均出现呼吸道症状,胸部CT示肺部斑片状实变影。患者给予葡萄糖及抗感染治疗后症状好转,纠正原发病因后,患者低血糖昏迷未再次发生。结论非糖尿病低血糖昏迷在临床上相对少见,应及时明确低血糖原因,同时不要忽略对吸入性肺炎等常见并发症的诊断和处理。

Objective To investigate the clinical features, diagnosis, treatment and prognosis of non-diabetic hypo-glycemia coma complicated with aspiration pneumonia. Methods Ten cases o f non-diabetic hypoglycemic coma with aspiration pneumonia were analyzed retrospectively to understand the clinical feature of this disease. Results Of the ten cases, there were four cases associated with alcohol poisoning, two with liver cirrhosis, one with dumping syndrome, one with chronic renal failure, one with hypoglycemic drugs and one with bladder cancer. The average value of random blood sugar was 1.3 mmol/L. All the patients developed respiratory symptoms within two days after coma. Chest CT test showed multiple patchy opacities in their lungs. After the treatment of glucose and anti-infection, the patientsJ symptoms improved significantly. With treating the primary cause of these cases, the hypoglycemic coma did not occur again during the follow-up period. Conclusions Non-diabetic hypoglycemia coma is not com-mon in clinic. The cause of hypoglycemia should be explored timely and the diagnosis and treatment of aspiration pneumonia and other complications can not be neglected.