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目的总结低血糖症的急诊处置方案,减少漏诊、误诊。方法对50例临床诊断低血糖症确立后的患者及时治疗。未昏迷患者,口服葡萄糖水200～300ml,观察病情变化,病情改善后鼓励进食。昏迷或嗜睡者低血糖症诊断确立后,静脉注射50%葡萄糖注射液40～60ml,观察病情变化,若病情无改善或改善欠佳,则继续静脉滴注10%葡萄糖注射液250～500ml,神志清醒后鼓励患者进食。抽搐者予镇定、吸氧等对症治疗,并执行同昏迷者一样补糖方案。结果 32例患者在口服葡萄糖液后症状迅速缓解。4例昏迷及9例昏睡患者在静脉注射葡萄糖过程中清醒,进食后1h内症状缓解,4例昏迷患者静脉注射葡萄糖后症状改善不佳,继续静脉滴注10%葡萄糖后神志清醒。50例患者接受治疗后全部痊愈出院,无不良反应及后遗症患者。结论多数低血糖症是可防可控的,仔细询问病史,积极补糖治疗低血糖症能取得理想效果。
Objective To summarize the emergency treatment plan of hypoglycemia and reduce the missed diagnosis and misdiagnosis. Methods 50 cases of clinically diagnosed hypoglycemia after the establishment of timely treatment. Patients who are not comatose, oral glucose water 200 ~ 300ml, observed changes in condition, to encourage eating after the condition improved. Coma or lethargy hypoglycemia diagnosis is established, the intravenous injection of 50% glucose injection 40 ~ 60ml, observed changes in condition, if the disease did not improve or improve poor, then continue intravenous infusion of 10% glucose injection 250 ~ 500ml, mind Encourage patients to eat after awake. Convulsions to be calm, oxygen and other symptomatic treatment, and implementation of the same co-glucose program with those who coma. Results The symptoms of 32 patients were relieved rapidly after oral glucose solution. 4 cases of coma and 9 cases of drowsiness in patients with intravenous glucose in the process of awake, symptoms within 1h after remission, 4 cases of coma patients intravenous glucose after the poor improvement of symptoms, continue to intravenous infusion of 10% glucose after conscious. All 50 patients were fully discharged after treatment, with no adverse reactions and sequelae. Conclusion Most hypoglycemia is preventable and controllable. Careful inquiry of medical history and active treatment of hypoglycemia can achieve the desired result.