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患者女,63岁,因意识不清、右侧肢体不能活动4小时,于1998年5月16日来我院急诊。患者6年前发现糖尿病,一直服降糖灵等药物治疗,血糖波动在11.2～13.8mmol/L,尿糖++～+++,半年前改服优降糖2.5mg,每日三次,当时查空腹血糖10.1mmol/L,尿素氮10.7mmol/L,两个月前患者食欲时好时差,查空腹血糖3.6mmol/L,尿糖阴性,尿素氮14.2mmol/L。就诊前一天家属发现患者意识萎靡,有时阵阵迷糊,喝糖水及进食能缓解,未吐,当日仍服优降糖。就诊当日上午发现患者呼之不应、尿床、右侧肢体不能活动。立即来我院急诊。患者有高血压病已10余年,糖尿病性肾病4年。查体:嗜睡状态,压眶有反应,双瞳孔等大,对光反射存在。血压 24/13kPa,右侧鼻唇沟稍
Female patient, 63 years old, because of confusion, the right limb can not move 4 hours, on May 16, 1998 to our hospital emergency room. Six years ago, patients were found to have diabetes mellitus and had been treated with hypoglycemic agents. The blood glucose was fluctuated between 11.2 and 13.8 mmol / L and urine sugar ++ to +++. Half a year ago, the patient was given oral hypoglycemic 2.5 mg three times a day. Blood glucose 10.1mmol / L, urea nitrogen 10.7mmol / L, two months ago when patients with good appetite time difference, check fasting blood glucose 3.6mmol / L, urine negative, urea nitrogen 14.2mmol / L. The day before treatment, the family members found that patients with apathetic, and sometimes bursts of drowsiness, drinking water and eating can ease, not spit, the day is still serving hypoglycemic. The morning of the day of treatment found that patients should not call, bed-wetting, the right limb can not move. Immediately to our hospital emergency room. Patients with hypertension have more than 10 years, 4 years of diabetic nephropathy. Physical examination: drowsiness, pressure orbital reaction, double pupil and so on, the presence of light reflex. Blood pressure 24 / 13kPa, right nasolabial groove slightly