更换胰岛素注射笔后出现的复发性糖尿病酮症酸中毒

• 作 者: Vishal Rai Bhardwaj Neil Metcalfe Emma Innes Esther Harrison David Jenkins 周海涛
• 机 构: South Worcestershire Centre for Diabetes and Metabolism Worcestershire Royal Hospital senior surgica
• 出 处: 英国医学杂志(中文版)
• 发表日期: 2006年04期
• 关键词: 胰岛素注射 胰岛素剂量 高酮血症 Ⅰ型糖尿病 高糖血症 代谢性酸中毒 西方国家 注射技术 总死亡率 酮症

糖尿病酮症酸中毒是由于胰岛素严重缺乏所致的糖尿病未经控制的严重状态,其特征为高糖血症、高酮血症以及代谢性酸中毒。在Ⅰ型糖尿病儿童患者中,糖尿病酮症酸中毒为其发病和死亡的主要原因,在西方国家中,其总死亡率为5％～10％。糖尿病酮症酸中毒的常见诱因包括感染和胰岛素剂量不足,后者是由于治疗无持续性、未能遵循“发病期”原则(在并发其他疾病时增加胰岛素用量的建议)和注射技术不佳所导致的。最近,我们遇到2例复发性糖尿病酮症酸中毒患者,是由于在更换预填充胰岛素注射装置过程中,未认识到其中的差异造成的。

Diabetic ketoacidosis is an uncontrolled, severe condition of diabetes due to a severe lack of insulin characterized by hyperglycemia, hyperkalemia and metabolic acidosis. Diabetic ketoacidosis is the leading cause of morbidity and mortality in children with type I diabetes, with overall mortality of 5% to 10% in western countries. Common causes of diabetic ketoacidosis include infection and inadequate insulin dosage, the latter due to noncontinuity of treatment, failure to follow the “period of onset” principle (recommendations for increasing insulin dosage when other diseases are complicated), and poor injection techniques Cause Recently, we encountered two patients with recurrent diabetic ketoacidosis because of the lack of awareness of the differences among them in the replacement of prefilled insulin injection devices.