摘要
目的总结以酮症酸中毒(DKA)为首发症状的糖尿病患儿的临床特点及诊治经过。方法回顾性分析32例以DKA为首发症状的糖尿病患儿的临床资料。结果 29例有多饮、多尿、消瘦表现;伴有呼吸道感染者16例,腮腺炎1例,尿路感染1例,消化道感染2例,有恶心、呕吐、腹痛等消化道症状者11例。32例均有精神差、呼吸深大及脱水表现。给予补液、纠正酸中毒和电解质紊乱、胰岛素治疗后,所有病例均好转出院。结论以DKA为首发症状的糖尿病临床症状不典型,多由感染诱发,局部感染症状表现突出,容易漏诊误诊。常规行血糖、血气分析、尿常规检查有助于诊断。一旦确诊后应立即予以补液、胰岛素降血糖、积极补钾、谨慎补碱等对症综合治疗。
Objective To discuss the clinical features, diagnosis and treatment in children with diabetic ketoacidosis （DKA） as the first symptom of diabetes mellitus. Methods Clinical data of 32 children with DKA as the first symptom of diabetes mellitus were investigated retrospectively. Results Twenty-nine patients had clinical features including polydipsia, polyuria and weight loss. There were 16 patients complicated with respiratory tract infec- tion, 1 patient with mumps, 1 patient with urinary tract infection, 2 patients with gastrointestinal infection. Eleven patients had gastrointestinal symptoms of nausea, vomiting and abdominal pain. Poor spirit, deep respiration, dehydra- tion existed in all the patients. All the patients were improved and discharged after treatment with fluid replacement, redress acidosis and electrolyte disturbance, insulin supplement. Conclusion Clinical manifestations of diabetes mellims with ketoacidosis as the first symptom are not specific. The inducement is always infection of which the symptoms are outstanding. It＇s easy to be ignored or make misdiagnosis. We should increase vigilance on DKA when the children have poor spirit or consciousness disorders, dehydration, deep respiration, vomiting and abdominal pain, unexplained fatigue or weight loss. Blood glucose, arterial blood gas analysis and urine examination should be checked and once the diagnosis is confirmed, the combined therapeutic measures are fluid replacement, insulin treatment,supplement of potassium actively and redress acidosis carefully.
出处
《海南医学》
CAS
2013年第8期1189-1191,共3页
Hainan Medical Journal
关键词
糖尿病
糖尿病酮症酸中毒
胰岛素
儿童
Diabetes mellitus
Diabetic ketoacidosis
Insulin
Children
