tory burch shoes 11 patients with diabetic hyperos

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11 patients with diabetic hyperosmolar coma with acute myocardial infarction

Cardiovascular and cerebrovascular disease. 1.2 Clinical manifestations in 3 cases of deep coma, coma time for 1 ~ 12h, blood pressure 11O ~ 7O/8O ~ 50mmHg. 100t150 heart rate beats / min. 4 cases of bilateral Palestinian-bin's sign positive. 1.3 laboratory blood glucose 33 ~ 56mmol / L, serum sodium 135 ~ 172mmol / L, which is greater than 150mmol/L9 cases; potassium 4.0 ~ 5.8mmol / L. Normal serum chloride, urea nitrogen 8.4 ~ 31mmol / L, serum creatinine increased liver> 177umol / L (of which increased in 2 cases), ketone (± ~ +) 2; the rest were negative. Blood leukocytes 10. O ~ 16.1 × 10. / L. All showed the number of neutrophils increased, according to the formula plasma osmolality 2 × (serum sodium + serum potassium) mmol / L + glucose mmol / L + BUN mmol / LE anterior and / or inferior wall, high lateral AMI, while with the dynamic evolution. myocardial enzymes were high. creatine kinase and lactate dehydrogenase isoenzymes were more than 2 times greater than normal,[link widoczny dla zalogowanych], troponin positive, 4 cases of Pakistan do Bin's sign positive head CT were normal. 1.4 treatment after admission, once diagnosed, immediate gastric tube inserted. by gastric tube into the warm water 150 ~ 200ml / h, and in accordance with hyponatremia adjust the infusion concentration of ingredients, if the serum sodium greater than 155mmol / L glucose and given 5 intravenous short-acting insulin, except in this isotonic glucose, insulin and outside to wait for another 6 ~ 10u / h insulin, if the serum sodium less than 155mmol / L intravenous saline and insulin (insulin 8 ~ 12u / h). also be subcutaneous low molecular weight heparin and nitroglycerin point. In the course of treatment, blood glucose throughout the entire term of insulin dose, while paying attention to potassium, support and symptomatic treatment 2. Results All patients turned clear mind in two days, the fastest for the 3h.4 cases of bilateral Palestinian-bin's sign were all positive to negative. 2 patients died of acute renal failure. Author: 014040 Mongolia Baotou, Inner Mongolia Hospital of Endocrinology, 2 patients died of heart failure, 7 patients surviving myocardial enzymes returned to normal. good blood glucose control, improved and discharged. 3 Discussion hyperosmolar nonketotic diabetic coma treatment lies in quickly to correct dehydration. decrease in plasma osmotic pressure and blood sugar. From a clinical perspective, most patients died of complications of high permeability. If water loss caused by hypovolemic shock,[link widoczny dla zalogowanych], hypercoagulable due to cerebral infarction, AMI. when combined with AMI, the rapid infusion, the incidence of heart failure increased risks. literature, through the tube so that liquid fluid absorption more in line with the physiological situation. and more quickly and safely. in the hypertonic state, with 5 intravenous glucose plus insulin, blood sugar does not cause significant increased [2]. Our practice has proved this point: myocardial infarction diabetic hyperosmolar coma when combined infusion of warm water by gastric tube. the one hand, reduce the heart load, on the other hand to reduce sodium intake. to prevent the blood further increase in sodium. to become a simple and feasible corrective hypertonic. also reduced the incidence of heart failure. The group had 4 patients with bilateral Palestinian-bin's sign positive, but no abnormal head CT. may be due to severe dehydration hypovolemia, in a temporary ischemic brain tissue, caused by hypoxia. be corrected dehydration, transient cerebral ischemia and hypoxia improved,[link widoczny dla zalogowanych], dual cases of Palestinian Bin's sign can be changed from positive to negative. The The pathological changes are not permanent. diabetic hyperosmolar coma due to blood coagulation, condensation, prone to thrombotic events. especially for the elderly. AMI is more likely. Once the AMI is larger infarct size. affect the prognosis. and most of for the elderly are advised not to thrombolytic therapy. We low molecular weight heparin for anticoagulation therapy. At the same time anti-shock with vasodilators and symptomatic treatment. to improve myocardial blood supply, as much as possible to save the dying heart muscle. that the elderly diabetic hyperosmolar coma conventional heparin may. especially the extensive use of low molecular weight heparin the bleeding side effects is much smaller than heparin [. on the merger were to be hyperosmolar AMI corrected. In the case of the disease allowed,[link widoczny dla zalogowanych], and feasible intervention. In view of this group of patients fewer. hypertonic low molecular weight heparin prevention of diabetes complicated by AMI's efficacy need further observation.

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