Elderly diabetic hyperosmolar hyperglycemic state care.docVIP

 PAGE \* MERGEFORMAT 9 Elderly diabetic hyperosmolar hyperglycemic state care Hyperosmolar hyperglycemia state (hyperosmolar hyperglycemic state HHS) also known as diabetes, high blood sugar crisis, ‘diabetic hyperosmolar nonketotic coma’ has used ‘hyperosmolar hyperglycemic state’ instead of the word. Because ① patients hyperosmolar state can exist disturbance of consciousness, but not necessarily manifested as coma, ② hyperosmolar hyperglycemic state can be associated with different levels of blood ketones increased. The disease is diabetes, the most serious acute metabolic complication. At present, even the experienced HHS hospital case fatality rate was still 15% in old age, there is state of coma and hypotension, the prognosis is even worse. January 2006 ~ December 2008 our department treated six cases of elderly patients with HHS, we have adopted is reasonable under the monitoring of central venous infusion, lower osmotic pressure, with micro-pump for continuous low-dose insulin injection, reduces blood sugar, close monitoring of vital signs, fluctuations in blood sugar, prevent the occurrence of other complications, strengthen basic care, to achieve satisfactory results, now nursing experience described below: A clinical data 6 cases of HHS patients, 2 males and 4 females, both in patients with type 2 diabetes, aged 62 to 78 years, blood glucose test results 38 ~ 58mmol / L, serum sodium 152 ~ 180mmol / L, plasma osmolality 348 ~ 415mmol / L. Drowsiness 2 cases, 3 cases of drowsiness, coma in 1 case. After treatment blood sugar dropped to 14mmol / L, plasma osmolality fell to 320mmol / L below the gradual return of consciousness, vital signs were stable in 5 cases, 1 patient on admission is already in deep coma due to severe dehydration, infection, circulatory failure, hospitalization she died within 24 hours. 2 Rescue 2.1 reasonable arrangements for rehydration, and actively correct the hyperosmolar state first establish two venous access, one fo