糖尿病低血糖昏迷的院前急救干预

目的：为了提高对低血糖昏迷的认识，减少误诊，提高院前急救水平，讨论快速血糖测定的必要性．方法：回顾性分析67例糖尿病低血糖昏迷患者的临床资料，其中现场行快速血糖检查后紧急处置61例，未行快速血糖检查仅给予一般急救处理6例。结果：49例在3－30min内慢慢苏醒，症状缓解及消失，其中6例患者清醒后要求不去医院，其余患者均到医院继续治疗。12例患者在急诊室留观，24小时反复监测血糖，病情稳定后出院，49例患者需住院观察治疗，其中6例未作院前血糖检测的患者均需住院治疗。7例院前检测低血糖昏迷的患者，回院后CT提示合并有脑血管意外收入院治疗。结论：院前急救必须配备快速血糖检测仪及相关药品，院前急救过程中对糖尿病病人出现任何神经系统症状时均应及时测定血糖，以区别低血糖昏迷和脑血管意外，做出及时处置避免发生不可逆性脑损害。

The Intervention of Pre-hospital Care for Hypoglycemia Coma of Diabetes

Objective：To raise awareness of hypoglycemia coma, reduce misdiagnosis and improve the level of pre--hospital care, we retrospectively analysed 67 cases of hypoglycemia coma of diabetes in my hospital for discussing the necessary of rapid blood glu- cose determination. Methods：We analysed the clinical data of 67 cases retrospectively. 61 cases were gived on--spot and rapid blood glucose determination and emergency treatment. 6 cases were given general emergency treatment and not given rapid blood glucose determination. Resuhs：49 cases come around slowly after 3-30mintes. Their symptom relieved and disappered. 6 cases of 49 cases were not in hospital, the rest were in hospital for further treatment. 12 cases stayed in the emergency room and were gived repeatly blood glucose determination in 24hours. They left hospital being in a stable condition. 49 cases needed hospitalization and observed, 6 cases of which who were absence of pre--hospital blood glucose determination needed hospitalization. 7 cases who were given pre-- hospital blood glucose determination were in hospital because of cerebral vascular accident through CT. Conclusions：The pre--hospital care must be equipped with the devices of rapid blood glucose determination and related drugs. TO distinguish between hypoglycemia coma and cerebral vascular accident and avoid irreversible damage of brain, the patients should be timely determinatised blood glucose during the course of pre--hospital care when they have any neurological symptoms.