高血糖高渗综合征（HHS）是一种缓慢发展的过程，特征为血糖水平显著增高，高渗透压和电解质异常。近几年，青少年人群中HHS的发病率稳步上升。HHS患者常常表现出严重的脱水、疲劳和早期的精神状态变化。HHS的急诊初期管理包括液体置换、血液动力学支持、纠正电解质紊乱以及处理并发症和潜在疾病。在HHS中，胰岛素不是首选治疗，只有在患者的液体和电解质得到补充后才需考虑使用。与糖尿病酮症酸中毒不同，HHS患者无酸中毒症状，尽管儿童可能表现为混合HHS/糖尿病酮症酸中毒综合征。HHS的并发症包括血栓形成、横纹肌溶解和罕见的恶性高热。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Hyperglycemic hyperosmolar syndrome (HHS) is an indolent process characterized by significantly increased levels of serum glucose, high osmolality, and electrolyte abnormalities. The incidence of HHS has steadily risen in the pediatric population over the past several years. Patients with HHS often present with profound dehydration, fatigue, and early mental status changes. Primary emergency management of HHS involves fluid replacement, hemodynamic support, correcting electrolyte derangements, and addressing complications and underlying illnesses. Insulin is not an initial therapy in HHS and should be considered only after the patient's fluids and electrolytes have been repleted. Unlike in diabetic ketoacidosis, HHS patients are not acidotic, although children may present with mixed HHS/diabetic ketoacidosis syndromes. Complications of HHS include thrombosis, rhabdomyolysis, and, rarely, malignant hyperthermia.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.