本文报道一例非酮症高渗性昏迷的老年糖尿病患者,经治疗高血糖高渗很快纠正。患者因神经性膀胱与前列腺肥大致尿路梗阻,饮水过多加重了尿潴留,出现梗阻性肾病——氮质血症、低比重尿、高钠高氯性昏迷。梗阻解除后,肾功能迅速恢复。本例教训:(1)凡合并神经性膀胱的老年男性糖尿病患者,要常规检查有无前列腺肥大;(2)下尿道梗阻可引起梗阻性肾病,使肾脏的滤过、排泌、浓缩功能受损,及时排除梗阻可使受损的肾功能恢复正常。 This article reports a case of non-ketotic hypertonic coma in elderly diabetic patients, the treatment of hyperglycemia quickly corrected. Patients with neurogenic bladder and prostatic hypertrophy caused by urinary tract obstruction, excessive drinking increased urinary retention, obstructive nephropathy - azotemia, low urinary, high sodium chloride coma. After the obstruction was relieved, the renal function recovered rapidly. Lessons learned in this case: (1) elderly male patients with diabetes mellitus with neurological bladder should be routinely checked for prostatic hypertrophy; (2) lower urinary tract obstruction may cause obstructive nephropathy, the filtration, excretion, concentration function of the kidneys Loss, timely obstruction can make the damaged kidney function returned to normal.