儿童糖尿病酮症酸中毒33例

The clinical analysis of 33 children with diabetic ketoacidosis

目的总结33例儿童糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床特点及诊治经过。方法对33例儿童DKA的临床资料进行回顾性分析。结果33例患者中有明确诱因69.7%,多饮多尿54.5%,意识改变48.5%,呼吸深大45.5%,腹痛、呕吐或腹泻等消化道症状33.3%。给予补液、纠正电解质紊乱及酸中毒,小剂量胰岛素(0.1U·kg-1·h-1)持续静脉注射等综合治疗,好转出院31例,死亡2例。结论儿童DKA多有诱因,主要表现为多饮多尿、腹痛、呕吐或腹泻、呼吸深大、意识改变,但无特异性。补液、小剂量胰岛素持续静脉注射是DKA治疗的主要措施。

Objective To discuss the clinical features, diagnosis and treatment in children diabetic ketoacidosis （DKA）. Methods Clinical data of 33 children with DKA were retrospective analysed. Results Of 33 cases,definite inducement for 69.7% ,polydipsia and polyuria for 54.5%, consciousness disorders for 48.5%, deep respiration for 45.5% ,stomachache,vomiting or diarrheao for 33.3%.All patients were treated with Combined Modality Therapy including fluid replacement, redress electrolyte disturbances and acidosis, insulin treatment et al. 31 cases improved excepting 2 cases died. Conclusion Clinical situation of DKA includes polydipsia and polyuria, consciousness disorders, deep respiration,stomachache,vomiting or diarrheao. But all they are not specific. Fluid replacement and insulin treatment are the key therapeutic measure for the children with DKA.