糖尿病酮症酸中毒合并梗阻性肾病1例并文献复习

Diabetic ketoacidosis with obstructive nephropathy of a case report and literature review

糖尿病酮症酸中毒是体内胰岛素不足或相对不足而导致的代谢紊乱,从而引起以高血糖、高酮血症和代谢性酸中毒为主要改变的临床综合征,是糖尿病最常见的容易危及生命的急性并发症,治疗上以大量补液、胰岛素降糖、纠正代谢性酸中毒为主要救治方法。本研究报道广东省中医院急诊科收治的1例在糖尿病酮症酸中毒基础上合并梗阻性肾病、急性肾衰竭的患者,由于病情复杂,治疗与单纯糖尿病酮症酸中毒大为不同,通过分析讨论本病例的治疗特点,提示临床需遵循个体化的原则,才能达到精准治疗的目的。

Diabetic ketoacidosis is a metabolic disorder caused by insufficient or relatively insufficient insulin in the body,which causes a clinical syndrome with hyperglycemia,hyperketemia,and metabolic acidosis as the main changes.It is the most common life-threatening acute complication of diabetes.The main treatment methods include large amounts of fluids,insulin hypoglycemia,and correction of metabolic acidosis.This article reports a case of diabetic ketoacidosis combined with obstructive nephropathy and acute renal failure in the emergency department of Guangdong Provincial Hospital of Chinese Medicine.Due to the complex condition,the treatment is very different from that of simple diabetic ketoacidosis.The treatment characteristics of the cases suggest that the principle of individualization must be followed in clinical practice to achieve the purpose of precise treatment.