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临床上典型的低血糖症较易诊断,而非典型低血糖症,尤其是低血糖危象,表现为突然偏瘫、昏迷、血压高为首发症状者诊断较困难。现报告三例如下:例1,女,58岁,因昏迷5小时以脑血管意外收入院。查:深昏迷,Bp21.3/13.3kPa,右瞳孔2.0mm,左瞳孔3.0mm,对光反应消失;右下肢呈外旋位,双侧 Babinski 氏征阳性。立即静注20%甘露醇250ml,病情未见好转,又静注50%葡萄糖100ml,20分钟后患者神志转清,两瞳孔等大,四肢活动自如,病理反射消失。此时方考虑到低血糖的可能,急检血糖为3.
Clinically, typical hypoglycemia is easier to diagnose, but not typical hypoglycemia, especially hypoglycemia crisis, manifested as sudden hemiplegia, coma, high blood pressure as the first symptom diagnosis more difficult. The following three reports are as follows: Example 1, female, aged 58, was admitted to the hospital for cerebrovascular accidents for 5 hours after a coma. Check: deep coma, Bp21.3 / 13.3kPa, right pupil 2.0mm, left pupil 3.0mm, disappeared on the light response; right lower extremity was external rotation, bilateral Babinski’s sign positive. Immediate intravenous injection of 20% mannitol 250ml, the condition did not improve, and intravenous injection of 50% glucose 100ml, 20 minutes after the patient consciousness clear, two pupils and other large, limbs freely, pathological reflex disappeared. At this point to consider the possibility of hypoglycemia, blood test for 3.