糖尿病酮症酸中毒胰岛素治疗的护理研究进展

Advances on nursing of insulin-treated diabetic ketoacidosis

糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)是由于体内胰岛素缺乏,胰岛素拮抗激素增加,引起糖和脂肪代谢紊乱,以高血糖、高血酮症和代谢性酸中毒为主要改变的临床综合征。DKA具有病情变化快、病情危重及发病迅速等特征。目前,临床上对于DKA发病机制尚不完全知晓,主要由于机体血糖激素过多或胰岛素缺乏造成电解质紊乱、继发性酸中毒、血酮体增加、脂肪分解增加及血糖升高等症状。目前常规治疗方法主要以纠正水、电解质紊乱和酸碱平衡等为主,该方法虽然能改善患者症状,但是长期疗效欠佳,预后较差。近年来,胰岛素治疗在DKA的治疗中应用广泛,该方法具有操作简单、安全性高等优势。现对DKA的诱因、临床表现,胰岛素在DKA中的应用及相关的护理措施等方面的研究作一综述,以有助于提高其临床治疗护理效果。

Diabetic ketoacidosis （DKA） arises due to a lack of insulin in the body and an increase of antagonistic hormone insulin, causing glucose/lipid metabolic disturbance, with hyperglycemia hyperketonemia, and metabolic acidosis as the main clinical manifestations. DKA is featured by quick changes, critical condition, and rapid onset. Clinically DKA pathogenesis is not fully understood at present, mainly resulting from electrolyte imbalance caused by glucose excess or insulin deficiency, secondary acidosis, increased blood ketone bodies, increased lipolysis, and elevated glucose. Currently, although conventional treatment to correct electrolyte and acid-base imbalance disorders can improve DKA symptoms, long-term efficacy and prognosis are not ideal. In recent years, insulin therapy is widely used in the treatment of DKA, which is advantaged by simple and safe operation. This review focused on DKA causes, clinical manifestations, insulin application, and related nursing measures in order to improve clinical nursing effect.