开颅术后高渗高糖非酮症昏迷的临床研究

摘要

Objective: To study the emergency treatment of nonketotic hyperosmotic hyperglycemic coma of post-craniotomy. Methods: Sixteen patients with post-craniotomy were measurably treated with intravenous transfusion, monitoring the central venous pressure, the plasma osmotic pressure was reduced to keep up with the rate of 2mOSM per litre an hour. The insulin was given. Results: 12 patients with hyperosmotic pressure were corrected, 10 cases were alive. Conclusions: The pathogenesis of nonketotic hyperosmotic hyperglycemic coma following craniotomy may be with responsibility for hypothalamus injured and administered dehydrant long time. The dominating factor of successful treatment for it is reducing plasmaosmotic pressure with appropriately speed of intravenous transfusion and rescue shock on time.%目的：提高开颅术后高渗高糖非酮症昏迷的抢救成功率。方法：对16例开颅术后高渗高糖非酮症昏迷病人在中心静脉压监测下合理补液，应用胰岛素，每h降低血浆渗透压2mOSM/L。结果：12例高渗得到纠正，10例存活。结论：丘脑下部损害及长时间大量使用脱水剂是本病主要病因，适当速度降低血渗，及时抢救休克是本病治疗成功的关键。