糖尿病合并败血症的临床特点分析

Analysis of Clinical Characteristics and Treatment of Diabetic Septicemia

目的探讨糖尿病合并败血症的临床特点,以提高临床诊断治疗水平。方法对26例糖尿病合并败血症患者的临床资料进行回顾性总结分析。结果 26例患者均有发热、寒战,24例白细胞总数升高。G-菌感染22例,其中肺炎克雷伯菌11例,大肠埃希菌10例。G+菌3例。感染途径分别为呼吸道(13例)、泌尿道(9例)、皮肤(2例)。经过处理,26例患者的体温在7～10d恢复正常,均获得满意的治疗效果。结论糖尿病合并败血症仍以G-菌多见,主要为肺炎克雷伯菌及大肠埃希菌。早期诊断,积极抗感染治疗,控制血糖,减少血糖波动利于改善预后。

Objective To investigate the clinical characteristics of patients with diabetic septicemias. Methods A retrospective clinical analysis was conducted on 26 patients with diabetic septicemias. Results All the patients had fever and chills,including 24 patients with elevated WBC. Gram-negative bacilli were detected in 22 patients,including 11 with Klebsiella pneumoniae and 10 with Escherichia coli. Grampositive cocci were observed in three individual patients. The main infection pathways consisted of respiratory tract（ n = 13） ,urinary tract（ n = 9） ,and skin（ n = 2） . After the treatment,the body temperature of all the patients returned to normal in 7-10 days. They all achieved satisfactory therapeutic goals. Conclusion Sepsis in diabetic patients was commonly associated with Gram-negative bacilli. Klebsiella pneumoniae and Escherichia coli were major pathogens. Sufficient antibiotic treatment,effective control of blood glucose with insulin and less glycaemic variability might contribute to the better prognosis.