糖尿病乳酸酸中毒13例救治体会

13 Subjects With Severe Diabetic Lactic Acidosis of Mass Burn Casualties

目的探讨应用持续静脉-静脉血液透析滤过(CVVHDF)治疗严重糖尿病乳酸酸中毒患者的疗效。方法回顾性分析2004年1月～2010年12月13例糖尿病乳酸酸中毒病例的临床资料。13例分为常规组5例和血液滤过组8例,监测两组患者治疗前后血乳酸、动脉血气、肾功能,分析CVVHDF清除乳酸的效果及患者的死亡率。结果两组患者血pH值上升水平、血乳酸、血尿素氮下降水平间差异均有显著性(P<0.05),血液滤过组优于常规组;血肌酐水平间差异无显著性(P>0.05),但两组病死率之间差异有显著性(P<0.05)。结论 CVVHDF能够提高糖尿病乳酸酸中毒患者的救治率。

Objective To evaluate the value of continuous veno-venous hemodiafiltration（CVVHDF） treatment of severe diabetic lactic acidosis.Methods 13 subjects with severe diabetic lactic acidosis in hospital were studied during January of 2004 to December of 2010.Patients were divided into regular group and CVVHDF group.The level of lactic acid,pH,BUN and Scr in plasma were detected before and after treatment.Results The fall speed of lactic acid level in plasma and raise speed of PH of arterial blood and BUN in plasma in two groups was significantly different（P0.05）,CVVHDF group was faster than regular one;the Scr in plasma in two groups had no difference（P0.05）.Significant difference of mortality rate in two groups was found（P0.05）.Conclusions CVVHDF can improve the treatment rate of lactic acidosis diabetes.