CAJ | 학술논문

目的：了解老年人低血糖脑病的临床特点，分析误诊原因，吸取教训，以提高诊治水平。方法对32例老年人低血糖脑病的临床资料作回顾性分析。结果初诊误诊12例，误诊率37.5％，被误诊为急性脑血管病8例，精神病1例，昏迷待查3例，诊断明确后即静脉注射50％ GS 40～100 mL ，15～30 min后神志清楚，6～8 h后局部神经体征消失，继之用5％或10％ GS静滴，以维持血糖稳定24～48 h ，经5～7 h监测血糖稳定后予以出院。结论以急性脑血管病首发的低血糖脑病，常见于老年糖尿病患者的用药过程中，临床医生应拓宽知识面，提高警惕，及时检测血糖，并迅速处理。
목적：료해노년인저혈당뇌병적림상특점，분석오진원인，흡취교훈，이제고진치수평。방법대32례노년인저혈당뇌병적림상자료작회고성분석。결과초진오진12례，오진솔37.5％，피오진위급성뇌혈관병8례，정신병1례，혼미대사3례，진단명학후즉정맥주사50％ GS 40～100 mL ，15～30 min후신지청초，6～8 h후국부신경체정소실，계지용5％혹10％ GS정적，이유지혈당은정24～48 h ，경5～7 h감측혈당은정후여이출원。결론이급성뇌혈관병수발적저혈당뇌병，상견우노년당뇨병환자적용약과정중，림상의생응탁관지식면，제고경척，급시검측혈당，병신속처리。
Objective To study the clinical features of hypoglycemia encephalopathy in elderly people ,and to analyze the reasons of misdiagnosis and improve how to diagnose and treat.Methods Retrospective analysis was done on clinical data of 32 elderly hypoglycemia encephalopathy patients received and cured from March 2007 to March 2013.Results 12 cases were mis‐diagnosed at the first time ,misdiagnosis rate was 37.5% ,including 8 cases of acutecerebrovascular disease ,1 case of mental disease ,3 cases of coma to be checked ,who received intravenous 50% glucose injection about 40‐100 mL after correct diagno‐sing ,then became clear in consciousness after15‐30 minutes ,and local neurological symptoms disappeared after 6‐8 hours ,5%or 10% glucose injection were continued to keep glucostasis for 24‐48 hours , discharged after glucostasis for 5‐7 hours.Conclusion Hypoglycemia encephalopathy initials with acute cerebrovascular disease are commonly seen in medication process of elderly diabetic ,clinicians should broaden scope of knowledge ,raise vigilance and detect blood glucose ,then dispose in time.