糖尿病低血糖临床特征观察与急诊诊治分析(1)
[摘要] 目的 探讨糖尿病低血糖临床特征观察与急诊诊治。方法 2015年1月—2018年12月该院急诊科诊治39例糖尿病低血糖患者，常规多参数监护，快速推注50%GS，继续静滴5%～10%GS，根据患者血糖水平、意识恢复等情况，随时调整用量，对于昏迷患者同时予以营养脑神经、促进脑代谢药物。结果 治疗后10 min～2 h内31例(79.49%，31/39)患者意识开始清醒，27例(87.10%，27/31)患者意识完全转清，8例(20.51%，8/39)血糖纠正后仍然昏迷。2 d内33例(84.62%，33/39)痊愈出院，住院继续治疗6例(15.38%，6/39)。2例(5.13%，2/39)抢救后出现反应迟钝等，1例(2.56%，1/39)因为多器官功能衰竭而死亡。 结论 糖尿病低血糖多发于老年人，具有一定特异性，急诊医师在接诊时详细询问病史，进行体检，并常规行血糖监测，以免漏诊误诊，以合理的治疗方案对患者进行治疗。
[关键词] 糖尿病;低血糖;特征;急诊;诊治
[中图分类号] R587.2 [文献标识码] A [文章编号] 1672-4062(2019)08(b)-0006-03
[Abstract] Objective To investigate the clinical features of hypoglycemia in diabetes and emergency diagnosis and treatment. Methods From January 2015 to December 2018， 39 patients with diabetes mellitus and hypoglycemia were treated in the emergency department of our hospital. The routine multi-parameter monitoring， rapid bolus injection of 50% GS， continued intravenous infusion of 5%-10% GS， according to the patient's blood glucose level， consciousness recovery conditions， adjust the dosage at any time， for the coma patients at the same time to nutrition brain， promote brain metabolism drugs. Results In the 10 min to 2 h after treatment， 31 patients (79.49%， 31/39) were conscious of consciousness， and 27 patients (87.10%， 27/31) had complete consciousness of consciousness， and 8 patients (20.51%， 8/39) had blood glucose being corrected but still in coma. 33 patients (84.62%， 33/39) were discharged from hospital within 2 d， and 6 patients (15.38%， 6/39) continued to be hospitalized. 2 patients (5.13%， 2/39) were unresponsive after rescue， and one patient (2.56%， 1/39) died of multiple organ failure. Conclusion Diabetes hypoglycemia is more common in the elderly and has certain specificity. The emergency doctors inquire about the medical history in detail during the consultation， conduct physical examination， and routinely monitor blood glucose to avoid misdiagnosis and to treat patients with reasonable treatment.
[Key words] Diabetes; Hypoglycemia; Characteristics; Emergency department; Diagnosis and treatment
糖尿病是临床常见疾病，在控制血糖的治疗中有患者可能产生低血糖的症状，低血糖的定义是指血浆葡萄糖浓度低于一定范围导致的多系统临床表现的综合征[1]，起病急，发病原因多样化，危及患者的生命安全，低血糖是急诊内科经常遇到的危重病，随着社会生活的日益激烈，低血糖患者已呈现不断上升的趋势[2]。该研究于2015年1月—2018年12月选取该院收治的39例糖尿病低血糖患者作为研究对象，对该院急诊科诊治的糖尿病低血糖患者进行分析，报道如下。
1 资料与方法
1.1 一般资料
该院急诊科诊治39例糖尿病低血糖患者，既往有明确存在糖尿病34例，病程6个月～13年，平均(6.02±2.31)年，11例应用胰岛素，9例应用磺脲类降糖药，应用其他降糖药物14例，存在各种糖尿病合并症23例(58.97%，23/39);初次确诊糖尿病患者5例(12.82%，5/39)。发病后到就诊时间为15 min～6 h，平均(2.25±1.07)h。男18例(46.15%，18/39)，女21例(53.85%，21/39)。年齡40～90岁，平均(68.97±9.88)岁，其中≥60岁共30例。急诊时血糖0.47～2.80 mmol/L，平均(2.07±0.33)mmol/L。, 百拇医药(王心怡)
[关键词] 糖尿病;低血糖;特征;急诊;诊治
[中图分类号] R587.2 [文献标识码] A [文章编号] 1672-4062(2019)08(b)-0006-03
[Abstract] Objective To investigate the clinical features of hypoglycemia in diabetes and emergency diagnosis and treatment. Methods From January 2015 to December 2018， 39 patients with diabetes mellitus and hypoglycemia were treated in the emergency department of our hospital. The routine multi-parameter monitoring， rapid bolus injection of 50% GS， continued intravenous infusion of 5%-10% GS， according to the patient's blood glucose level， consciousness recovery conditions， adjust the dosage at any time， for the coma patients at the same time to nutrition brain， promote brain metabolism drugs. Results In the 10 min to 2 h after treatment， 31 patients (79.49%， 31/39) were conscious of consciousness， and 27 patients (87.10%， 27/31) had complete consciousness of consciousness， and 8 patients (20.51%， 8/39) had blood glucose being corrected but still in coma. 33 patients (84.62%， 33/39) were discharged from hospital within 2 d， and 6 patients (15.38%， 6/39) continued to be hospitalized. 2 patients (5.13%， 2/39) were unresponsive after rescue， and one patient (2.56%， 1/39) died of multiple organ failure. Conclusion Diabetes hypoglycemia is more common in the elderly and has certain specificity. The emergency doctors inquire about the medical history in detail during the consultation， conduct physical examination， and routinely monitor blood glucose to avoid misdiagnosis and to treat patients with reasonable treatment.
[Key words] Diabetes; Hypoglycemia; Characteristics; Emergency department; Diagnosis and treatment
糖尿病是临床常见疾病，在控制血糖的治疗中有患者可能产生低血糖的症状，低血糖的定义是指血浆葡萄糖浓度低于一定范围导致的多系统临床表现的综合征[1]，起病急，发病原因多样化，危及患者的生命安全，低血糖是急诊内科经常遇到的危重病，随着社会生活的日益激烈，低血糖患者已呈现不断上升的趋势[2]。该研究于2015年1月—2018年12月选取该院收治的39例糖尿病低血糖患者作为研究对象，对该院急诊科诊治的糖尿病低血糖患者进行分析，报道如下。
1 资料与方法
1.1 一般资料
该院急诊科诊治39例糖尿病低血糖患者，既往有明确存在糖尿病34例，病程6个月～13年，平均(6.02±2.31)年，11例应用胰岛素，9例应用磺脲类降糖药，应用其他降糖药物14例，存在各种糖尿病合并症23例(58.97%，23/39);初次确诊糖尿病患者5例(12.82%，5/39)。发病后到就诊时间为15 min～6 h，平均(2.25±1.07)h。男18例(46.15%，18/39)，女21例(53.85%，21/39)。年齡40～90岁，平均(68.97±9.88)岁，其中≥60岁共30例。急诊时血糖0.47～2.80 mmol/L，平均(2.07±0.33)mmol/L。, 百拇医药(王心怡)