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目的总结45例儿童糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床特点及诊治经过。方法对45例儿童DKA的临床资料进行回顾性分析。结果 45例患者中有明确诱因69.7%,多饮多尿54.5%,意识改变22.3%,腹痛、呕吐或腹泻等消化道症状54.2%。经扩容,小剂量胰岛素持续静脉滴注,消除诱因,纠酸控感染,维持水电解质平衡等综合治疗后45例均抢救成功。结论儿童DKA多有诱因,主要表现为多饮多尿、腹痛、呕吐或腹泻、呼吸深大、意识改变,但无特异性。补液、小剂量胰岛素持续静脉注射是DKA治疗的主要措施,早发现,早治疗明显提高抢救成功率。
Objective To summarize the clinical features and diagnosis and treatment of diabetic ketoacidosis (DKA) in 45 children. Methods The clinical data of 45 children with DKA were retrospectively analyzed. Results Among the 45 patients, 69.7% had definite inducement, 54.5% had polyhydramnios, 22.3% changed their consciousness, 54.2% had digestive symptoms such as abdominal pain, vomiting or diarrhea. After the expansion, continuous infusion of small doses of insulin, to eliminate incentives, correct acid infection control, maintaining water and electrolyte balance and other comprehensive treatment of 45 cases were successfully rescued. Conclusion There are many causes of DKA in children, mainly manifested as polyhydramnios, abdominal pain, vomiting or diarrhea, deep breathing, change of consciousness, but no specific. Rehydration, small doses of insulin continuous intravenous injection of DKA is the mainstay of treatment, early detection and early treatment significantly improve the success rate of rescue.