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糖尿病患者手术麻醉病例概况糖尿病（DM）诊断和分型糖尿病（DM）流行病学糖尿病（DM）流行病学糖尿病（DM）流行病学糖尿病（DM）流行病学DM相关并发症强直性关节综合征DM相关并发症心血管疾病DM相关并发症心血管疾病DM相关并发症微血管病变DM相关并发症微血管病变DM相关并发症微血管病变DM相关并发症微血管病变DM相关并发症神经病变DM急性并发症酮症酸中毒DM急性并发症酮症酸中毒DM急性并发症高血糖性高渗性昏迷DM急性并发症高血糖性高渗性昏迷DM的治疗DM的治疗DM的治疗本例患者如何评估术前评估术前评估术前评估术中管理术中管理术中管理术中管理术中管理术中管理术中管理Neuroglycopenicsymptomsofhypoglycemiaarethedirectresultofcentralnervoussystem(CNS)glucosedeprivation.Theyincludebehavioralchanges,confusion,fatigue,seizure,lossofconsciousness,and,ifhypoglycemiaissevereandprolonged,death.Neurogenic(orautonomic)symptomsofhypoglycemiaaretheresultoftheperceptionofphysiologicchangescausedbytheCNS-mediatedsympathoadrenaldischargetriggeredbyhypoglycemia.Theyincludeadrenergicsymptoms(mediatedlargelybynorepinephrinereleasedfromsympatheticpostganglionicneuronsbutperhapsalsobyepinephrinereleasedfromtheadrenalmedullae)suchaspalpitations,tremor,andanxiety.Theyalsoincludecholinergicsymptoms(mediatedbyacetylcholinereleasedfromsympatheticpostganglionicneurons)suchassweating,hunger,andparesthesias.Clearly,thesearenonspecificsymptoms.Theirattributiontohypoglycemiarequiresacorrespondinglowplasmaglucoseconcentrationandtheirresolutionaftertheglucoselevelisraised(Whipple'striad).Commonsignsofhypoglycemiaincludediaphoresisandpallor.Heartrateandsystolicbloodpressurearetypicallyraised,butthesefindingsmaynotbeprominent.Neuroglycopenicmanifestationsareoftenobservable.Transientfocalneurologicdeficitsoccuroccasionally.Permanentneurologicdeficitsarerare.术中管理谢谢糖尿病（DM）流行病学DM相关并发症微血管病变DM相关并发症微血管病变DM急性并发症高血糖性高渗性昏迷术中管理术中管理
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