Horiuchi A, Nawa S, Miyachi Y, Yamamoto T, Tsuji K, Hayashi K
Department of Surgery, Junkankika-hayashi Hospital.
Kyobu Geka. 1990 May;43(5):397-400.
A 56-year-old man without a past history of diabetes mellitus underwent aortic valve replacement. On the 8th postoperative day, the patient became confused with a peak blood glucose level of 600 mg/dl and peak serum osmolarity level of 411 mOsm/l, without ketotic urine. The diagnosis of hyperosmolar hyperglycemic non-ketotic coma (HHNKC) was made, and the patient was immediately treated with massive infusion of 0.45% saline water and continuous insulin administration, and the patient could completely recover. It is important to prevent and keep in mind the complication of HHNKC for the postoperative care after open heart surgery.
一名既往无糖尿病病史的56岁男性接受了主动脉瓣置换术。术后第8天，患者出现意识模糊，血糖峰值水平为600mg/dl，血清渗透压峰值水平为411mOsm/l，尿中无酮体。诊断为高渗高血糖非酮症昏迷（HHNKC），患者立即接受大量0.45%盐水输注和持续胰岛素治疗，最终完全康复。对于心脏直视手术后的术后护理，预防并牢记HHNKC并发症很重要。
