摘要
目的比较在第一个小时内口服结合静脉补液对1型糖尿病酮症酸中毒fDKA）青年患者血糖等指标的影响。方法将64例T1DM并发DKA的青年患者随机分为观察组和对照组各32例，观察组在抢救开始的第一个小时内给予口服或胃管内注入液体1000ml，同时补充快递静脉补液1000ml，并给予微泵控制胰岛素注射速度；对照组仅给予常规静脉补液1500ml。比较抢救前及补液1小时后的血糖、血酮及血气分析结果。结果治疗前两组患者血糖、血酮等指标差异无显著性（P〉0．05）；治疗后两组患者上述指标均较抢救前改变俨〈0．05）；治疗后两组患者的血糖、血酮、pH及PaCO2差异均有统计学意义（P〈0．05）。观察组2例患者出现轻度胃扩张；对照组1例血压升高、呼吸困难，1例心律失常。结论在第一个小时内口服温开水结合静脉补液，有助于降低T1DM并发DKA的青年患者的血糖及血酮，更加有效地纠正酸中毒。
Objective To evaluate the fluid infusion effect of first hour impact on the indexes including blood sugar of the young patients undergoing type 1 diabetes mellitus （T1DM） complicated with diabetic ketoacidosis （DKA）. Methods 64 young T1DM patients complicated with DKA were randomly divided into the observation group and control group （n=32 for both groups）; the former 32 cases in the first hour was given oral or stomach tube injection liquid with 1000 ml, and at the same time added express intravenous fluid infusion for 1000 ml and given micro pump control insulin injection speed. The control group was only given 1500 ml fluid via intravenous infusion. We compared the blood sugar, blood ketone and blood gas analysis results before and after first hour fluid infusion. Results Two groups of patients before the rescue of blood sugar, blood ketone indices showed no statistical difference （P〉0.05）; the two groups after treatment with the above specifications were changed significantly （observation group before and after blood sugar was t=5.828, P=0.006; blood ketone was t=2.164, P=0.023. Control group blood sugar compared as t=-4.112, P=0.013; blood ketone was t=-2.037, P=0.033）. 1 hour after two groups＇ blood sugar, blood ketone, pH and PaCO2 were statistically significant （P= 0.025, 0.032, 0.037 and 0.034 respectively）, the observation group＇ s blood sugar, blood ketone and PaCO2 were lower （P 〈 0.05）, and the pH higher （P 〈 0.05）. In the prognosis of two groups, shock, the incidence of kidney failure were not statistically different. Conclusion The method which combines oral way with intravenous infusion in the first hour is proved to be .more effective on reducing the blood glucose and ketone for the young patients undergoing T 1 DM complicated with DKA.
出处
《国际医药卫生导报》
2013年第8期1086-1088,共3页
International Medicine and Health Guidance News
关键词
1型糖尿病
并发症
酮症酸中毒
补液
血气分析
Type 1 diabetes mellitus （T1DM）
Complications
Diabetic Ketoacidosis （DKA）
Fluid infusion
Blood gas analysis
