To be alert to hyperosmolar coma!
Posted on October 22, 2009
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(1) prognosis. Diabetic hyperosmolar coma mortality rate is high or low depends largely on early diagnosis and complications of treatment, about 28% of patients in the hospital died within 48 hours after the main hypertonic. Hyperosmolar state, therefore the longer the duration of the higher mortality rate, while a variety of complications, especially infections, is the leading cause of death late. Therefore, a variety of complications from the outset, must be very great importance, particularly in the beginning of infection should be given a large dose of effective antibiotic treatment.
(2) preventive measures. Due to diabetic hyperosmolar coma in time even if the diagnosis, treatment, active, mortality remains high, thus actively preventing extremely important. Specific measures include the following:
① early detection and strict control of diabetes.
② prevention and treatment of various infections, stress, high fever, gastrointestinal water loss, burns and other conditions in order to avoid hyperosmolar state.
③ to avoid the use of drugs such as elevated blood glucose diuretics, corticosteroids, propranolol, pay attention to all kinds of dehydration therapy, high-nutrient flow juice, peritoneal dialysis and blood caused by dehydration.
④ on the middle-aged patients, regardless of whether there is a history of diabetes if the following conditions, it should be vigilant against the occurrence of this disease, immediately for laboratory examination (check blood glucose, potassium, sodium, chloride, urea nitrogen, urine sugar and ketone bodies, CO-binding capacity):
there is a progressive disturbance of consciousness and obvious dehydration performance of persons;
b are the central nervous system symptoms and signs, such as epileptic seizures and pathological reflex positive sign;
c In the infection, myocardial infarction, surgery and other cases, there is more than stress urinary persons;
d in the large intake of sugar or application of certain medications caused by elevated blood sugar, there were many changes in urine and awareness;
e amount of water into the history of those who are inadequate or dehydration.
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