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崔××,女69a,因右侧肢体无力20d,左侧肢体无力3d,加重1d入院,诊断为多发性脑梗死,糖尿病,酮症酸中毒.治疗上主要以血塞通和腹蛇抗栓酶溶栓,以改善脑代谢;以格列本脲(glibenclamide)合用盐酸二甲双胍(dimethyl biguamidehydrochloride)治疗糖尿病.患者于4月9日服格列本脲5mg bid,4月11日合用二甲双胍25mg tid,17日下午(即给格列本脲8d,盐酸二甲双胍6d后),突然意识不清,唤之反应迟钝.体检:BP:135/60mmHg(18/8kPa),心率80beats/min,律齐,血糖1.37mmol/L.急予50%GS100ml,iv,神志逐渐清晰,体征尚稳定,暂停降糖药,给5%GS500ml维持,次日10:00测血糖9.57mmol/L),神志清.
Cui × ×, female 69a, due to the right limb weakness 20d, left limb weakness 3d, aggravating 1d admission, diagnosis of multiple cerebral infarction, diabetes, ketoacidosis. Treatment mainly with Xuesaitong and abdominal snake antithrombotic Enzyme thrombolysis to improve cerebral metabolism Glibenclamide combined with dimethyl biguamide hydrochloride for diabetic patients Glibenclamide 5 mg bid on April 9 and metformin 25 mg tid on April 11, BP: 135 / 60mmHg (18 / 8kPa), heart rate 80beats / min, Qi Qi, blood glucose (blood sugar) was measured on the afternoon of the 17th (ie, after glyburide 8d and metformin hydrochloride 6d) 1.37mmol / L. Emergency 50% GS100ml, iv, consciousness gradually clear, the phenomenon is still stable, hypoglycemic agents suspended to 5% GS500ml maintain the next day 10:00 test glucose 9.57mmol / L), the spirit of clear.