Yudkin J S, Doyal L T, Hurwitz B S
Department of Medicine, University College and Middlesex School of Medicine, Whittington Hospital, London.
Lancet. 1987 Nov 21;2(8569):1192-5. doi: 10.1016/s0140-6736(87)91330-4.
Discussion of the case of a patient admitted to hospital with decompensated diabetes revealed a conflict in attitudes to resuscitation of the patient from that disorder and from cardiac arrest. A survey was sent to 200 diabetologists and 200 cardiologists in the United Kingdom, asking about their management of diabetes and their therapeutic approaches to cardiac arrest for 3 elderly patients admitted with severe decompensated diabetes. The response rate was poor (27%) but the answers showed that all 3 patients were more likely to be resuscitated from decompensated diabetes than from cardiac arrest. Possible reasons for a different approach to the two conditions are discussed, and suggestions are put forward for a greater involvement by patients in decisions about future resuscitation.
对一名因糖尿病失代偿而入院的患者的病例讨论揭示了对于该患者由糖尿病失代偿和心脏骤停进行复苏的态度存在冲突。向英国的200名糖尿病专家和200名心脏病专家发送了一份调查问卷，询问他们对3名因严重糖尿病失代偿而入院的老年患者的糖尿病管理情况以及对心脏骤停的治疗方法。回复率很低（27%），但答案显示，所有3名患者因糖尿病失代偿而进行复苏的可能性都高于因心脏骤停进行复苏的可能性。讨论了对这两种情况采取不同方法的可能原因，并提出了让患者更多地参与未来复苏决策的建议。
