Analysis of the Efficacy of Intravenous Combined with Nasogastric Fluid Replacement versus Intravenous Fluid Replacement Alone in the Treatment of Diabetic Hyperosmolar Hyperglycemic State

FU Yongju; MA Mingzhen

doi:10.13919/j.issn.2095-6274.ZHJY202507039

Abstract：Objective To compare and analyze the efficacy and safety of intravenous fluid replacement combined with nasogastric fluid replacement versus intravenous fluid replacement alone in the emergency treat-ment of patients with diabetic Hyperosmolar Hyperglycemic State(HHS).Methods A retrospective cohort study was conducted,enrolling 78 HHS patients admitted to our hospital from January 2023 to January 2025.After balancing baseline characteristics between groups using Propensity Score Matching(PSM,1∶1 matching,caliper value=0.02),60 patients were included in the analysis.They were divided into a combined rehydration group(in-travenous+nasogastric,n=30)and a sole intravenous rehydration group(n=30).Clinical efficacy,laboratory pa-rameters(blood glucose,plasma osmolality,electrolytes),recovery process(shock correction time,consciousness recovery time,osmolality normalization time,and hospital stay),and complication rates were compared between the two groups.Results The total clinical effective rate was significantly higher in the combined rehydration group than in the sole rehydration group(96.67％vs.76.67％,P=0.023),and the total incidence of complications was lower(6.67％vs.26.67％,P=0.038).After treatment,the combined rehydration group showed better control of blood glucose,plasma osmolality,and serum sodium levels compared to the sole rehydration group(P＜0.001),and also demonstrated better recovery of serum potassium(P=0.005).Furthermore,the observation group(combined rehydration)had significantly shorter times for shock correction,consciousness recovery,osmolality normalization,and hospital stay(P＜0.001).Conclusion In the emergency treatment of diabetic Hyperosmolar Hyperglycemic State,combined nasogastric fluid replacement,compared to intravenous fluid replacement alone,can more effec-tively correct metabolic disturbances,accelerate patient recovery,and reduce the risk of complications,repre-senting a superior fluid replacement strategy.