急诊糖尿病低血糖临床诊治探析.docVIP

急诊糖尿病低血糖临床诊治分析 　　【摘要】 目的：探讨急诊糖尿病低血糖临床诊断及防治措施。方法：选择本院2012年1月-2015年10月收治的糖尿病低血糖患者50例作为研究对象，根据病情严重程度不同实施相应的急救措施，给予甜食、糖水或者水果等含高糖分的食物；50%葡萄糖注射液快速静脉注射，并配合脑细胞营养剂及吸氧等相关措施进行应对；昏迷状态超过3 h的患者给予20%甘露醇静脉注射；治疗中血糖指数反复下降时，联合适量地塞米松静脉点滴。结果：经过针对性的治疗，47例（94.00%）患者血糖均恢复到正常状态，且病情也有所改善，临床症状与临床体征逐渐消退。抢救后出现反应迟钝、昏迷状态等2例（4.00%），死亡1例（2.00%）。结论：低血糖症多发生于老年糖尿病患者，其临床表现形式多种多样，诱发原因较多，对患者危害大，容易误诊漏诊。急诊医生应对此提高警惕，加深认识，提高其早期诊断率，正确治疗改善患者预后 【关键词】 糖尿病； 低血糖； 特征； 治疗 中图分类号 R587.2 文献标识码 B 文章编号 1674-6805（2016）17-0104-02 【Abstract】 Objective：To investigate the clinical diagnosis and emergency treatment on diabetic hypoglycemia prevention and control measures.Method：Fifty patients with diabetic hypoglycemia admitted to our hospital from January 2012 to October 2015 were chosen as the research objects，the corresponding emergency measures were implemented according to their different illness severity，give sweets，sugar water or fruits and other food with high-carbohydrate，50% glucose intravenous quickly injection，nutrients of brain cells，oxygen inhalation and other relevant measures were given cooperated with the emergency measures，20% mannitol intravenous injection was given to patients with a coma for more than 3 hours.Moderated dexamethasone intravenous drip were combined when the glycemic index reduced repeatedly.Result：Through the targeted therapy，the blood glucose of 47 cases（94.00%） returned to normal status，and the diseases were also improved，the clinical symptoms and signs were faded away.Two cases（4.00%） appeared slow in reacting and coma after the rescue，1 case（2.00%） was dead.Conclusion：Hypoglycemia mostly develops in the elder patients with diabetes，which has various clinical manifestations，a variety of causes，large damages to patients，and prone to misdiagnosis in diagnosis，the emergency physicians should be alert to this，deepen the understanding to increase the early diagnostic rate，improving the prognosis of patients with correct treatment. 【Key words】 Diabetes； Hypoglycemia； Characteristic；