【摘要】 目的探讨糖尿病酮症酸中毒(DKA)的发病诱因、临床特点及防治措施。方法选择近年来收治的DKA患者29例,对其临床资料进行回顾性分析。结果本组29例中1型DM6例,2型DM23例;既往有糖尿病史24例。DKA诱发因素中感染最多见,其次为降糖药物中断或使用不当、劳累、手术或创伤、饮食不当等,大多数DKA患者均具有两个以上的诱发因素,3例患者无明显诱因。经小剂量胰岛素持续静脉滴注、补液、纠正电解质紊乱及酸中毒、去除诱因等综合治疗后27例病情好转,4~11h血糖降至13.9mmol/L内;酮体转阴时间平均为(18.9±5.8)h。死亡2例,其中1例死于重症感染,1例死于肾功能衰竭。结论DKA发病诱因复杂,可引起一系列严重的代谢紊乱,若不能及时诊断并有效处理,可危及患者生命。给予小剂量胰岛素为主的综合治疗是救治DKA的有效措施,消除诱因,早期正确诊断及治疗是降低DKA死亡率的关键。更多还原

【Abstract】 Objective Approach to inducing factors,clinical characteristics and salvaging methods of diabetic ketoacidosis (DKA).Methods To retrospectively analyze the 29 DKA in-patients of our hospital.Results 6 patients are of type I diabetes mellitus (DM),23 patients of type II DM among 29 patients; 24 patients with a past history of diabetes.Infection is the most common inducing factor of DM,other factors are withdrawal or misuse of hypoglycemic drugs,exertion,operation,trauma,improper diet and so on,most DKA patients has over 2 inducing factors,only 3 patients report no inducing factor.Conclusion Drip of small dose of insulin,correct the derangement of water and electrolytes and remove inducing factors therapy achieved satisfactory effect on 27 patients,blood glucose drops below 13.9 mmol/L in 4-11 h; average recovering time of ketone bodies is(18.9±5.8)h.2 patients died,one die of severe infection,the other die of renal failure.Conclusion:complicated inducing factors of DKA can result a series of severe metabolic disorder.Delayed diagnosis and improper management can jeopardize patient’s life.Comprehensive therapy involving continuous drip of small dose of insulin is the effective management of DKA,prevention of inducing factors,promptly diagnosis and treatment is the key to reduce the death rate of DKA.更多还原