糖尿病酮症酸中毒合并高脂血症性急性胰腺炎病例分析

Case ananlysis of diabetic ketoacidosis complicated with hyperlipidemic acute pancreatitis

目的了解糖尿病酮症酸中毒合并高脂血症性急性胰腺炎的特点,以提高临床诊治水平。方法本研究将6例糖尿病酮症酸中毒合并高脂血症性急性胰腺炎患者作为研究对象,通过正确的病情评估、合理的液体复苏、迅速有效的降糖降脂、个体化的营养支持以及抑酸、抑制胰酶、脏器功能支持、预防感染等集束化治疗,观察腹痛缓解情况,血糖、酮体、pH、淀粉酶、脂肪酶、甘油三酯变化趋势和疾病转归。结果通过上述治疗,腹痛明显缓解,8小时内血糖降至13.9mmol/L以下,pH恢复正常,甘油三酯水平在48小时之内降至5.65mmol/L以下,淀粉酶、脂肪酶在治疗第5天趋近正常,6例患者均痊愈出院。结论正确的病情评估、合理的液体复苏、迅速有效的降糖降脂、个体化的营养支持以及抑酸、抑制胰酶、脏器功能支持、预防感染等集束化治疗对糖尿病酮症酸中毒合并高脂血症性急性胰腺炎具有良好的治疗效果。

Objective To understand the character of diabetic ketoacidosis（ DKA） complicated with hyperlipidemia acute pancreatitis（ HLAP）. Method Study on 6 cases of DKA patients complicated with HLAP,treated with illness assessment,fluid resuscitation,adjustment of blood glucose and triglyceride,nutritional support,control p H and pancreatin,organ support,prevention of infection,and so on. We observed abdominal pain,blood glucose,ketone,p H,amylase,lipase and triglyceride. Result Through the above treatment,abdominal pain relief,blood glucose dropped to 13. 9mmol / L in eight hours,p H returned to normal,TG level fell to 5. 65 mmol / L in forty-eight hours,Amylase and lipase reached normal treatment for 5 days,six patients were cured. Conclusion The treatment with assessment,reasonable fluid resuscitation,quickly and effectively reducing sugar and lipid,individualized nutritional support,acid suppression and inhibition of trypsin,organ function support,prevention of infection has a good therapeutic effect for DKA complicated with HLAP.