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目的 探讨糖尿病高渗性昏迷患者有效渗透压变化特点与预后的关系。方法 分析我院53 例确诊的糖尿病高渗性昏迷患者有效渗透压的变化情况,将患者每日有效渗透压的变化进行对比分析,观察其对预后的直接影响。结果 53例患者,有效渗透压≥370mmol/L的发生率及病死率分别为37 .7%、55%;有效渗透压<370mmol/L的发生率为62 .3%,发生率虽高,但易纠正,病死率低(为6 .1%),两组病死率有显著性差异(P <0.05)。其中有效渗透压≥370mmol/L持续3d以内及持续3d以上的病死率分别为42 .8%、83 .3%,病死率差异亦有显著性(P<0.05)。结论 有效渗透压显著增高及持续性高渗状态是糖尿病高渗性昏迷患者致死的危险因素。
Objective To investigate the relationship between the changes of effective osmotic pressure and prognosis in hypertrophic diabetic coma. Methods The changes of effective osmolality in 53 patients with hyperosmolar coma diagnosed in our hospital were analyzed. The changes of effective daily osmolality were compared and the direct effects on prognosis were observed. Results The incidence and mortality of effective osmolality of 370mmol / L were 37.7% and 55% respectively in 53 patients. The effective osmolality of 370mmol / L was 62.3%, but the incidence was high. However, Easy to correct, low mortality (6.1%), two groups of significant differences in mortality (P <0.05). The effective mortality of ≥370mmol / L within 3d and lasting for more than 3d were 42.8% and 83.3%, respectively. The mortality was also significantly different (P <0.05). Conclusion The significant increase of effective osmotic pressure and persistent hyperosmolarity are risk factors of lethality in patients with hyperosmolar coma.