【摘要】 高血糖高渗状态是一种严重的糖尿病急性并发症,其临床特征为严重的高血糖、脱水、血浆渗透压升高而无明显的酮症酸中毒,伴电解质紊乱,多为高钠血症。该病伴低钠血症合并高钾血症临床少见。其导致严重心律失常时可危及生命。本文报告1例高血糖高渗状态、低钠血症、高钾血症、严重缓慢心律失常及晕厥、陈旧性心肌梗死、心力衰竭患者,经合理补液、胰岛素降糖、纠正电解质紊乱、提升心率等治疗后好转。更多还原

【Abstract】 Hyperglycemic hyperosmolar state is a diabetic emergency,which characterized by severe hyperglycemia,hyperosmolality,dehydration in absence of ketoacidosis and electrolyte disturbance most of which is hypernatremia. It is not widely reported that hyperglycemic hyperosmolar state complicated with hyponatremia and hyperkalemia which may induce the life-threatening arrthymias. We share a case of hyperglycemic hyperosmolar state who had previous history of myocardial infarction and showed hyponatremia,hyperkalemia and syncope because of bradyarrhythmia. Successful treatments include fluids replacement,insulin administration,anti-arrhythmia drugs and proper strategy of controlling electrolyte disorders.更多还原