低血糖伴意识障碍92例临床剖析.docVIP

低血糖伴意识障碍92例临床剖析 　　【摘要】 目的 总结低血糖伴意识障碍患者的临床特征。方法 回顾性分析2003年11月至2009年8月收治的92例低血糖伴意识障碍患者的临床资料。病因:2型糖尿病和1型糖尿病降糖药物应用不当分别为78例、3例,酒精中毒3例,Sheehan综合征并垂体危象3例,肿瘤2例,急性肠炎2例,功能性低血糖1例。预后:良好82例,差10例。结果 应用口服降糖药物与胰岛素者预后比较差异有统计学意义(P0.05),不同预后者意识障碍时间及初诊血糖比较差异有统计学意义(P0.05)。结论 对低血糖伴意识障碍患者,应在尽快积极纠正低血糖的同时针对病因治疗,有助于改善预后。 　　【关键词】低血糖;意识障碍 　　 　　Clinical analysis of hypoglycemia associated conscious disturbance 　　 　　SUN Shi-an,YAN Li-jun,LIU Jun-ping,et al. 　　Outpatient Department,Xinjiang Autonomous Regional Corps Hospital, Chinese People’s Armed Police Forces, Urumqi 830091, China 　　 　　【Abstract】 Objective To analyze the clinical character of patients with hypoglycemia associated conscious disturbance.Methods To review and analyze the clinical data of 92 patients with hypoglycemia associated conscious disturbance.Cause:There were 78 inappropriate uses of glucose-lowering drugs in type 2 diabetes and 3 in type 1 diabetes, 3 alcoholic poisoning, 3 Sheehan Symptom associated pituitary crisis, 2 carcinoma, 2 acute enteritis and 2 functional hypoglycemia. Prognosis: There were 82 favourable but 10 unfavourable outcome.Results There was statistically significant difference in prognosis between patients using oral glucose-lowering drugs and insulin(P0.05). And, there was also statistically significant difference in duration of conscious disturbance and primary blood glucose between patients with different prognosis(P0.05).Conclusion To the patients with hypoglycemia associated conscious disturbance, it will contribute to good prognosis to retrieve hypoglycemia as soon as possible and take etiological treatment actively. 　　【Key words】 Hypoglycemia; Conscious disturbance 　　 　　低血糖是常见临床表现,当出现脑功能受累时,患者常可伴有不同程度的意识障碍。现通过对2003年11月至2009年8月收治的92例低血糖伴意识障碍患者的临床资料进行分析,总结其临床特征如下。 　　1 临床资料 　　1.1 一般资料 92例患者中男49例,女43例;年龄18～83岁,平均(57±18.7)岁。经积极处理,全部病例血糖恢复正常。其中2型糖尿病单纯口服降糖药物剂量调整不当或自行加药者34例,占37.0%;2型糖尿病同时应用胰岛素者共44例,占47.8%,其中剂量调整不当者43例(其中16例为胰岛素皮下注射同时口服磺脲类降糖药物,1例三餐前应用短效动物胰岛素),注射胰岛素种类错误者1例(误将赖脯胰岛素当作甘精胰岛素睡前皮下