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胰岛素所致之稽廷昏迷是胰岛素昏迷治疗中的最严重并发症,约占受治病例的2.1～17％。现报告1例。 病历摘要 男,24岁,精神分裂症。于第6次胰岛素昏迷治疗肌注胰岛素240U时出现第一次昏迷反应,鼻饲糖水及静注葡萄糖后意识恢复。3h后又出现躁动,给皮下注射吗啡10mg及东莨菪硷0.3mg后安静入睡,未进午餐。12时许静注33.3％葡萄糖100ml。下午1时半发现患者昏迷不醒,立即进行抢救。采用积极的对症措施,意识始终未完全恢复,长期处于去皮质状态,靠人工喂养。4年后死于全身衰竭及肺部感染,先后两次气脑造影示脑室普遍扩大,呈进行性。 尸检所见。死后12h进行尸检。检查见肺、肝、脾、
Insulin-induced statin coma is the most serious complication of insulin coma treatment, accounting for about 2.1 to 17% of treated cases. Now report 1 case. Medical summary Male, 24 years old, schizophrenia. In the sixth insulin coma treatment of intramuscular insulin 240U when the first coma reaction, nasogastric sugar and intravenous glucose recovery after consciousness. After 3h and restlessness appeared, to subcutaneous injection of morphine 10mg and scopolamine 0.3mg quiet sleep, did not enter lunch. 12 o’clock intravenous injection of 33.3% glucose 100ml. 1:30 found the patient unconscious, immediate rescue. With positive symptomatic measures, awareness has not been fully restored, long-term in cortex status, by artificial feeding. Four years later, he died of systemic failure and lung infection. Venous angiography twice successively showed ventricular enlargement and progression. See the autopsy. 12h after death for autopsy. Check see the lungs, liver, spleen,