Small M, MacCuish A C
Scott Med J. 1987 Apr;32(2):35-7. doi: 10.1177/003693308703200201.
Hyperosmolar non-ketotic coma is a relatively uncommon but important medical emergency. It is associated with a high mortality, which has changed little over the past twenty years. Approximately half of all patients give no prior history of diabetes and since patients often present with neurological abnormalities, resembling a cerebrovascular accident, the diagnosis can sometimes be delayed or missed. Therefore every patient presenting to hospital with a state of clouded consciousness or objective signs of neurological abnormality, should have a blood glucose estimation performed at an early stage. It has been suggested that a regimen of less aggressive early fluid replacement, with more attention being directed to the associated or underlying problems, may be beneficial to the patient. Claims that the continuing high mortality in non-ketotic coma can be improved by such measures await confirmation.
高渗性非酮症昏迷是一种相对罕见但重要的医疗急症。它与高死亡率相关，在过去二十年中死亡率变化不大。所有患者中约有一半既往无糖尿病史，且由于患者常表现出类似脑血管意外的神经异常，有时诊断会延迟或漏诊。因此，每一位意识模糊或有神经异常客观体征入院的患者，都应在早期进行血糖检测。有人提出，采取不太激进的早期补液方案，更多关注相关或潜在问题，可能对患者有益。通过这些措施能否改善非酮症昏迷持续居高不下的死亡率，还有待证实。
