Craniotomy hyperosmolar hyperglycemic nonketotic coma in 6 cases.docVIP

 PAGE \* MERGEFORMAT 4 Craniotomy hyperosmolar hyperglycemic nonketotic coma in 6 cases Authors: Shi Qiang, Liu industry, Yun-Feng Yang, Ling Cheng Ming [Keywords:] craniotomy; hypertonic; high blood sugar; coma In the craniotomy hyperosmolar hyperglycemic nonketotic coma, a serious condition, the treatment is very difficult, clinical mortality rate is very high, now I have discovered in recent years of the six cases of hospital after craniotomy hyperosmolar hyperglycemia nonketotic coma following report. A clinical data This group of 4 males and 2 females, aged from 25 to 60 years. Diagnosis of pituitary tumor in 2 cases, craniopharyngioma in 1 case, traumatic intracranial hematoma in 3 cases of postoperative hernia. Of these, 5 patients without a history of diabetes. Preoperative check blood sugar to normal, 6 cases were endotracheal intubation anesthesia craniotomy to remove the tumor and to remove the hematoma. After mannitol and dexamethasone and other conventional treatment. After hyperosmolar hyperglycemic nonketotic coma, which found that elevated blood sugar during the 3 d 2, respectively Li, 5,7,8,10 d in 1 case; dehydration Level: 3 cases of moderate dehydration, sodium 145 ~ 150 mmol / L, moderate and severe water loss in 3 cases, serum sodium 150 ~ 175 mmol / L; sense of change: from the sober to the three cases of coma, shallow coma in 1, persistent coma in 2 cases and found that blood glucose value of 25.5, 26.2,28,30.1,32.4,34.6 mmol / L in 1 case. Urine were strongly positive, Ketone 3 cases weakly positive, 3 negative, complications: pneumonia in 2 cases, gastrointestinal bleeding in 1, pneumonia and renal failure in 3 cases, treatment results: 2 patients were cured and 4 deaths. 2 Discussion 2.1 The incentives and pathogenesis of Craniotomy caused by hyperosmolar hyperglycemic nonketotic coma may be related to the following factors: (1) traumatic stress. In the stress state, elevated levels of hypothalamus pituitary hormone-relea