摘要探讨蛛网膜下腔出血并发糖尿病高渗性昏迷的发病机制、临床特点和治疗效果.回顾性分析7例蛛网膜下腔出血并发糖尿病高渗性昏迷患者的临床资料.所有患者均以严重脱水、意识障碍加深为主要临床表现.死亡3例,植物生存l例,恢复良好3例.结果 显示蛛网膜下腔出血所致下丘脑功能受损是高渗形成的重要原因,而高血糖的渗透利尿作用又加剧了这一过程.对蛛网膜下腔出血并发糖尿病高渗性昏迷患者救治的关键是积极补液,同时连续性监测血糖、血清渗透压,及时有效调整胰岛素用量.

abstractsDiscuss the pathogenesis, clinical features and treatment of subarachnoid hemorrhage with diabetic hyperosmolar coma. Retrospective analysis the clinical data of 7 cases on subarachnoid hemorrhage with diabetic hyperosmolar coma. All patients were in severe dehydration, unconsciousness deepened as the main clinical manifestations. 3 died and 1 case of plant survival, good recovery in 3 cases. Subarachnoid hemorrhage due to hypothalamic dysfunction is an important reason for the formation of high permeability, and high blood glucose can increase the penetration of the diuretic effect of the process. Of subarachnoid hemorrhage patients with diabetic hyperosmolar coma, the key is active rehydration treatment, and continuous monitoring of blood glucose,serum osmolality, timely adjustment of insulin dosage.