兰翠萍

[摘要] 目的 总结和分析糖尿病低血糖症患者的临床特点、治疗措施及相关诱发因素。 方法 选择2010年6月~2012年11月本院收治的50例糖尿病低血糖症患者为研究对象，回顾性分析其临床资料，总结其临床特点、治疗措施及相关诱发因素。 结果 20例患者有交感神经兴奋的症状，7例患者语言功能障碍且偏瘫，17例患者精神异常，嗜睡或昏迷，3例患者多次抽搐，3例患者胸闷胸痛。35例由于降糖药物治疗不当引起，8例由于饮食因素引起，7例由于患者自身因素引起，药物因素导致低血糖症的发生率为70.00%，明显高于其他诱因（P<0.05）。经过治疗后45例患者低血糖症状得到改善，2例患者出现记忆力明显减退、反应迟钝后遗症，1例遗留轻度痴呆后遗症，1例遗留痴呆后遗症，成植物状态，1例抢救无效死亡。 结论 糖尿病低血糖症主要由饮食、药物、合并症等因素引发，及早诊断和治疗、合理饮食、劳逸结合及合理用药是提高预后的关键。

[关键词] 糖尿病低血糖症；临床特点；诊治分析

[中图分类号] R587.1[文献标识码] B[文章编号] 1674-4721（2014）06（b）-0164-03

Clinical features and analysis of diagnosis and treatment of patients with diabetic hypoglycemia

LAN Cui-ping

Department of Endocrinology,People′s Hospital of Yizhou City in Guangxi Zhuang Autonomous Region,Yizhou 546300,China

[Abstract] Objective To investigate the clinical features,treatment and related predisposing factors of patients with diabetic hypoglycemia. Methods 50 cases of patients with diabetic hypoglycemia in our hospital from June 2010 to November 2012 were selected as study.The research data were reviewed and clinical features,treatment and related predisposing factors were analysed. Results 20 cases of patients were with symptoms of sympathetic nerve,7 cases of patients were with language dysfunction and paralysis,17 cases of patients were with mental abnormalities and drowsiness or coma,3 cases of patients were with repeated convulsions,3 cases of patients were with chest pain.35 cases were due to improper antidiabetic drug therapy,8 cases were caused by dietary factors,7 cases were due to the patient′s own factors,the incidence of hypoglycemia caused by drug factors was 70.00%,higher than that of the other incentives,the difference was significnat (P<0.05).After treatment,45 cases of patients′ symptoms of hypoglycemia were improved,2 cases of patients had significant memory loss and unresponsive sequelae,1 case of mild dementia sequelae legacy,1 case of dementia legacy sequelae,into a vegetative state,1 case was died. Conclusion The key of diabetic hypoglycemia are mainly caused by diet,drugs,complications and other factors.Early diagnosis and treatment,proper diet,and rest and rational use of drugs can improve prognosis.

[Key words] Diabetic hypoglycemia;Clinical features;Diagnosis and treatment

糖尿病是一组以高血糖为特征的代谢性疾病。高血糖是由于胰岛素分泌缺陷或其生物作用受损引起[1]。糖尿病时长期存在的高血糖可导致眼、肾、心脏、血管、神经等各种组织的慢性损害或功能障碍。糖尿病低血糖症指的是因为治疗不当或其他原因导致的血糖持续性过低的现象，最常见的低血糖原因为胰岛素治疗和磺脲类药物治疗不当[2]。轻则出现低血糖症状，重则意识障碍发生低血糖性昏迷。低血糖是糖尿病治疗中常见的一种并发症，临床误诊率较大，由此延误抢救时机造成患者脑组织发生不可逆损伤的不在少数，如果诊断不及时或抢救不当还会遗留相关后遗症，甚至危及生命健康[3]。本文探讨糖尿病低血糖症患者的临床特点、治疗措施及相关诱发因素。……