広範な脳障害のため意識障害と失語症を伴った糖尿病患者の血糖および水・電解質のコントロール

概要

論文の詳細を見る
Two diabetic patients with disturbance of consciousness and aphasia developing hyperglycemia and water-electrolyte imbalance were reported. Case 1 had multiple cerebral infarctions including left middle cerebral artery areas, right frontotemporal and occipital areas and left areas of pontine and midbrain. Case 2 had anoxic encephalopathy secondary to the cardiac resuscitation for the cardiac arrest. They had been in a state of the long-term lying in bed. They developed easily hyperglycemia and elevation of serum sodium and chloride concentrations after fever and dehydration : the blood glucose level elevated up to 622 mg/dl and the serum sodium concentration up to 161 mmol/l in case 1 and the blood glucose up to 562 mg/dl and serum sodium up to 167 mmol/l in case 2. These laboratory changes were accompanied by changes of facial expressions or eye movements, increase of pulse rate, lowering of the blood pressure and decrease of the urinary output. The patients were treated with intravenous saline and intragastric water administration and frequent administration of short acting insulin according to changes of blood glucose level. To care for the patient with disturbance of consciousness and aphasia, constant detail observations of the patient's conditions are essential.
香川県立保健医療大学の論文