Sauve D O, Kessler C A
AACN Clin Issues Crit Care Nurs. 1992 May;3(2):350-60. doi: 10.4037/15597768-1992-2007.
Hyperglycemic emergencies are the most common endocrinopathies that require intensive care. It is estimated that between 10% and 15% of patients admitted to intensive care units experience complications of acute hyperglycemia. The common denominator of hyperglycemic emergencies is diabetes mellitus, a group of diseases in which, either because of beta-cell destruction of the pancreas or insulin receptor-site defects, there is a relative or absolute deficiency of insulin that results in hyperglycemia. In response to various precipitating factors, staggering hyperglycemia may develop in the form of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNK). The existence of DKA has been known since ancient times, and critical care nurses are familiar with the diagnosis. The more lethal disorder of HHNK was "rediscovered" in the 1950s and is occurring with greater frequency as clinical awareness of the condition grows and the elderly (who are at greatest risk for the disorder) populate critical care units in increasing numbers. Prevention is instrumental in abating deadly hyperglycemic emergencies. A positive outcome can be realized but only with timely diagnosis and prompt hormonal and fluid replacement.
高血糖急症是最常见的需要重症监护的内分泌疾病。据估计，入住重症监护病房的患者中有10%至15%会出现急性高血糖并发症。高血糖急症的共同特征是糖尿病，这是一组疾病，由于胰腺β细胞破坏或胰岛素受体位点缺陷，导致胰岛素相对或绝对缺乏，从而引起高血糖。针对各种诱发因素，可能会以糖尿病酮症酸中毒（DKA）或高血糖高渗非酮症综合征（HHNK）的形式出现严重的高血糖。DKA的存在自古就为人所知，重症护理护士对其诊断很熟悉。HHNK这种更致命的疾病在20世纪50年代被“重新发现”，随着临床对该病症认识的提高以及老年人（该病症的高危人群）越来越多地入住重症监护病房，其发病率也在不断上升。预防对于减轻致命的高血糖急症至关重要。只有及时诊断并迅速进行激素和液体补充，才能取得积极的治疗效果。
