Hyperosmolar nonketotic diabetic coma treatment of 40 cases of.docVIP

 PAGE \* MERGEFORMAT 3 Hyperosmolar nonketotic diabetic coma treatment of 40 cases of Hyperosmolar nonketotic diabetic coma hyperosmolar coma for short [1], is a severe acute complication of diabetes to one of its main features are: severe high blood sugar, dehydration, and plasma osmotic pressure increased, without a clear ketoacidosis, patients often have progressive disturbance of consciousness or coma. The disease mostly occurs in more than 50 years of age, the old chaff urine of patients, a high fatality rate, timely and effective life-saving treatment is essential. Now in our hospital from January 1998 to January 2007 were treated 40 cases of hyperosmolar coma treatment of patients as follows. A clinical data 1.1 General Information 40 patients, the male 22 cases, female 18 cases, aged 50 to 75 years with a mean age of 61.5 years old, are in line with hyperosmolar coma diagnostic criteria. 6 cases of heart disease in which the merger, the merger kidney disease, 12 cases with cerebral vascular disease in 3 cases. 1.2 clinical manifestations of 40 patients, there are obviously more than drink, eat, polyuria, weight loss, fatigue in 21 cases; All the cases were tongue dry, orbital depression, skin loses elasticity and other severe dehydration sign; 8 cases of confusion, lethargy 10 cases, 22 cases of coma; 26 cases with normal blood pressure, high in 4 cases, low in 10 cases. 1.3 Laboratory tests are blood glucose 33.3mmol / L or more, up to 86.3mmol / L; sodium is greater than or equal to 150mmol/L32 cases, less than 150mmol/L8 cases; 36 cases of elevated blood urea nitrogen and creatinine; carbon dioxide combining power is less than 11mmol/L16 cases, Ketone weak positive in 8 cases and negative in 32 cases, 40 patients with white blood cells were significantly increased total plasma osmotic pressure were greater than 350mOsm / L, the effective osmotic pressure were greater than 320mOsm / L [2]. 2 Treatment 2.1 great plot rehydration 40 patients, bot