糖尿病酮症酸中毒合并高血糖高渗状态急诊救治体会

Experience of Emergency Treatment for Patients with Diabetic Ketoacidosis Complicated with Hyperglycemic Hyperosmolar Status

目的 探讨糖尿病酮症酸中毒（DKA）合并高血糖高渗状态的急诊救治方法。方法 回顾性分析15例患者的急诊救治方法。结果 患者经过临床治疗后，15例患者中有4例患者死亡，分别死于呼吸衰竭、心力衰竭、死于肾衰竭、心肌梗死；11例患者经过2～5 d纠正水电解质紊乱、降糖，对因对症等综合治疗后，有效血浆渗透压降至正常范围，尿酮体转阴，脱水得到纠正，电解质恢复正常，再经过1～3d的治疗后，昏迷、嗜睡等症状消失，病情稳定。结论 对于DKA合并高血糖高渗状态患者，尽早确诊，采取积极的治疗是有效的。

Objective] To explore the methods of emergency treatment for patients with diabetic ketoaci‐dosis（DKA） complicated with hyperglycemic hyperosmolar status（HHS） .[Methods] The methods of emer‐gency treatment for 15 patients with DKA complicated with HHS were analyzed retrospectively .[Results]Af‐ter clinical treatment ,4 patients died of respiratory failure ,heart failure ,renal failure and myocardial infarc‐tion ,respectively .After effective treatment for 2~5 days ,the effective plasma osmotic pressure of 11 patients decreased to the normal range ,and urine acetone bodied became negative ,and dehydration was corrected ,and electrolytes recovered .After 1~3 day of treatment again ,the coma ,drowsiness and others symptoms had dis‐appeared and the condition of patients was stable .[Conclusion] Patients with DKA complicated with HHS should be diagnosed as early as possible .Active treatment is effective .