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目的报道糖尿病酮症酸中毒(DKA)横纹肌溶解(RM)并致急性肾功能衰竭的临床诊治经验。方法 2009年10月8日收治1例DKA患者,病程中出现意识障碍、RM、急性肾功能衰竭,行连续性血液净化治疗。结果 48h后患者意识障碍恢复,血肌酸激酶下降,酸中毒纠正,治疗效果显著。结论提高对DKA患者发生RM的认识和常规肌酶谱的动态监测,做好早期诊断以及预防极其重要,是RM合并急性肾损伤(AKI)治疗的关键,有利于提高糖尿病患者的生存率。
Objective To report the clinical diagnosis and treatment of diabetic ketoacidosis (DKA) and acute renal failure. Methods One patient with DKA was admitted on October 8, 2009. There was disturbance of consciousness, RM, acute renal failure and continuous blood purification in the course of the disease. Results 48h after recovery of patients with disturbance of consciousness, decreased serum creatine kinase, acidosis corrected, the treatment effect is remarkable. Conclusion To improve the understanding of RM in DKA patients and the dynamic monitoring of routine muscle enzymes, to make early diagnosis and prevention is extremely important. It is the key to the treatment of AKI with RM, which is beneficial to improve the survival rate of diabetic patients.