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目的探讨糖尿病酮症酸中毒(DKA)的临床特点及综合治疗措施,减少漏、误诊,提高抢救成功率。方法对2005年7月-2012年6月佛山市南海区罗村医院收治的42例DKA患者的临床及实验室资料及抢救、治疗过程进行回顾性分析。结果 42例DKA患者中既往有糖尿病病史的38例,既往无糖尿病史、以DKA为首发症状就诊的4例;有明显诱因的39例,其中感染30例,自行减少降糖药及停用胰岛素6例,胰岛素失效1例,创伤1例,妊娠1例。入院时平均血糖(31.0±3.6)mmol/L,CO2CP(12.0±2.2)mmol/L,血、尿酮体皆阳性;治愈、好转41例,死亡1例。结论提高对DKA的认识,做到早诊断、早治疗,及时补液和持续静脉注射小剂量胰岛素是提高DKA抢救成功率的关键。
Objective To investigate the clinical features and comprehensive treatment of diabetic ketoacidosis (DKA), reduce leakage and misdiagnosis, and improve the success rate of rescue. Methods The clinical and laboratory data of 42 DKA patients admitted to Luocun Hospital, Nanhai District, Foshan City from July 2005 to June 2012 were retrospectively analyzed. Results Among the 42 DKA patients, there were 38 patients with previous history of diabetes mellitus, 4 patients with no previous history of diabetes mellitus, and 4 patients with DKA as the first symptom. Of the 39 patients with obvious predisposition, 30 patients were infected with antidiabetic drugs and insulin 6 cases, 1 case of insulin failure, 1 case of trauma and 1 case of pregnancy. The mean blood glucose (31.0 ± 3.6) mmol / L and CO2CP (12.0 ± 2.2) mmol / L on admission were positive in both blood and urine ketone bodies. Among them, 41 were cured and improved, and 1 died. Conclusions To improve the understanding of DKA and achieve early diagnosis, early treatment, prompt rehydration and sustained intravenous injection of small doses of insulin is the key to improve the success rate of DKA rescue.