酮症酸中毒抢救中疑难问题的探讨

Study of Problems in Rescuing Patients with Ketoacidosis

目的 总结 32例酮症酸中毒 (DKA)临床诊疗经验 ,探讨抢救中的疑难问题。 方法 分析近年住院的危重DKA病案 ,归纳救治疑难问题及处置方法。 结果 32例患者中 ,合并高渗性非酮症高血糖昏迷(HONK) 5例 ;入院时无尿、高血钾 3例 ;顽固性呕吐 2例 ;合并脑血管意外 4例 ;心衰、心律失常 6例、心梗 1例。结论 DKA合并严重并发症 ,是导致死亡的重要原因。诊疗中应分析DKA和继发病症的相互关系 ,统筹兼顾 。

Objective To summarize data of DKA 32 cases,explore the problems of the rescuing.Methods Analyze the cases of DKA patients in hospital in last 5 years(14 male,18 female).Results In 32 cases,there are 5 cases combined with HONK,anuria and hyperkalemia 3 cases,obstinate vomiting 2 cases,heart failure of arrhythmia 6 cases,AMI 1 case.Conclusion The significant reason of higher mortality rate in DKA is the severe complication.To raise the survival rate,we must analyze interrelation between DKA and complications carefully so htat to make precise treatment.