摘要
目的分析40例貌似脑血管意外的低血糖反应患者的临床表现、实验室检查、影像学检查及临床误诊的原因。方法观察我院5年内收治的低血糖反应患者,分别行头颅CT及实验室检查(包括血糖,电解质、肾功能等),筛出貌似脑血管意外的低血糖反应患者。结果绝大部分低血糖反应患者首诊均误诊为脑血管意外而收治入院,行CT检查未见明显新梗死或出血灶,后证实为低血糖反应,纠正低血糖后患者迅速恢复。34例很快清醒,临床症状消失,2例住院期间反复出现低血糖反应,4例仍昏迷不醒。结论临床对于急性意识障碍及类似脑卒中患者,尤其是昏迷病人,常规首先监测血糖水平,排除低血糖反应,尤其是老人、有糖尿病史及不正常饮食者。
Objective To analyze clinical features, laboratory examinations, imaging examinations and reasons for clinical misdiagnosis in 40 patients with hypoglycemic reaction similar to cerebrovascular accident. Methods Clinical observations had been carried out in 56 patients with hypoglycemic reaction in this hospital from 2003 to now. All these patients were examined by cranial CT scanning and laboratory examinations （ including levels of blood sugar, electrolytes, function of kidney etc）. All patients with hypoglycemia reaction similar to cerebrovascular accident were sifted out for study. Results Most of patients with hypoglycemic reaction had been misdiagnosed as cerebrovascular accident at first consuhation, but there was no sign of new cerebral infarction or hemorrhage by CT scanning, and they got rapid restoration after correction of hypoglycemia. Consciousness was quickly recovered in 34 cases and all their clinical symptoms disappeared, but hypoglycemia reaction repeatedly appeared in 2 cases during hospitalization and 4 cases still kept at comatose status. Conclusion Patients with acute unconscious disorder especially in comatose status should routinely monitor the level of blood glucose for excluding hypoglycemic reaction, particularly in eider patients with diabetes mellitus and abnormal drinking trencherman.
出处
《临床和实验医学杂志》
2008年第4期8-9,11,共3页
Journal of Clinical and Experimental Medicine
关键词
低血糖反应
脑血管意外
脑功能障碍
Hypoglycemia reaction
Cerebrovascular accident
Brain dysfunction
