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目的探讨以类似急性脑血管病为表现的低血糖症临床特点及应吸取的教训。方法对社区医院2007年1月~2014年5月期间收治的类似急性脑血管病为表现的低血糖症24例患者低血糖发生原因、确诊情况、临床表现及其治疗方法进行分析总结。结果 14例患者有低血糖发生原因(感染、腹泻、未及时监测血糖等);24例患者均发生不同程度昏迷,20例低血糖昏迷前仅表现嗜睡,4例有交感神经兴奋表现;发生四肢瘫痪6例,单侧瘫痪10例(均为右侧);低血糖昏迷发生时间在夜间10例,发生在上午8例,发生在下午6例;确诊糖尿病低血糖昏迷后立即予50%葡萄糖4O~6O ml静脉注射,继予10%葡萄糖维持静脉滴注。结论在糖尿病诊治过程中,一定要密切监测低血糖的发生,低血糖发生往往均有诱发因素。对昏迷患者常规立即做快速血糖测定十分重要。
Objective To investigate the clinical features and lessons of hypoglycemia with acute cerebrovascular disease. Methods The causes, diagnosis, clinical manifestations and treatment of hypoglycemia in 24 patients with hypoglycemia who were treated by similar acute cerebrovascular diseases in community hospital from January 2007 to May 2014 were analyzed and summarized. Results 14 patients had the causes of hypoglycemia (infection, diarrhea, not timely monitoring of blood sugar, etc.); 24 patients had different degrees of coma, 20 hypoglycemic coma before only show drowsiness, 4 patients have sympathetic nerve stimulation performance; Paralysis in 6 cases, unilateral paralysis in 10 cases (both on the right); hypoglycemic coma occurred in the night 10 cases, occurred in the morning of 8 cases, occurred in the afternoon of 6 cases; confirmed diabetes hypoglycemia coma immediately to 50% glucose 4O ~ 6Oml intravenous injection, followed by 10% glucose to maintain intravenous drip. Conclusion In the course of diagnosis and treatment of diabetes, we must closely monitor the occurrence of hypoglycemia, hypoglycemia are often predisposing factors. It is important to routinely perform rapid blood glucose measurements in unconscious patients.