儿童糖尿病合并酮症酸中毒17例临床特点分析

目的分析小儿糖尿病酮症酸中毒的临床表现及治疗效果。方法对17例儿童糖尿病酮症酸中毒的临床表现、实验室检查及可能引起的t误诊进行总结分析。结果经过小剂量胰岛素持续静脉应用及对症治疗,17例患儿均抢救成功。结论及时正确诊断,积极抢救,且小剂量胰岛素静脉滴注治疗小儿糖尿病酮症酸中毒是成功的关键。     

48例糖尿病酮症酸中毒及昏迷的临床治疗分析

目的：探讨糖尿病酮症酸中毒及其昏迷的发病原因及临床治疗的效果;方法：收集近年来我院收治的48例糖尿病酮症酸中毒厦昏迷患者治疗情况的临床资料,并根据患者不同的年龄结构分成两组进行分析研究,探讨糖尿病酮症酸中毒及昏迷患者入院治疗的临床效果;结果：48例糖尿病酮症酸中毒及昏迷患者经过入院定期观察治疗,病灶得到缓解;结论：糖尿病酮症酸中毒及昏迷患者中以中老年人,尤其是老年人居多,发病的患者要坚持长期补充血容量,坚持用胰岛素治疗,并纠正电解质厦酸碱平衡失调。对于轻微患者要早诊断,早发现,早治疗,防止发生并发症,通过合理治疗并坚持锻炼身体病情会得到缓解。     

糖尿病酮症酸中毒的治疗体会

目的:探讨糖尿病酮症酸中毒的治疗。方法:对21例糖尿病酮症酸中毒患者的临床资料进行回顾性分析。结果:呼吸道感染为其主要的诱因。经积极治疗后,21例糖尿病酮症酸中毒患者均痊愈出院。结论:早期诊断,正确治疗,去除诱因,保护多脏器功能,是抢救糖尿病酮症酸中毒成功的关键。     

产程中的胎儿监护

胎心率受到自主神经系统、化学感受器等多因素影响,是胎儿心脏和延髓对母胎血供、酸中毒和缺氧情况的反映。产时胎心监护用于评估胎儿宫内情况,可分为三级胎心率。根据产时胎心监护对患者进行科学分级管理,将有利于及时识别和处理胎儿宫内缺氧和酸中毒,预防胎儿死亡。     

妊娠合并酮症酸中毒

妊娠合并酮症酸中毒是一种可危及孕妇与胎儿生命的严重并发症,由于妊娠期的生理改变,发生酮症的易感性增加。本文主要阐述了妊娠期发生酮症酸中毒的发生机制、诱因、对母儿的风险及处理。     

卵巢早衰激素补充治疗

卵巢早衰是育龄期女性常见的一种妇科内分泌疾病,它不仅导致月经异常、绝经症状、不孕,还会使患者更早出现骨质疏松和心血管疾病,因此早期诊断与治疗至关重要。目前主要治疗方法是激素补充治疗,而且要比正常绝经女性更加积极地动员患者使用激素补充治疗。     

卵巢过度刺激综合征的防治

卵巢过度刺激综合征是一种医源性并发症.本文通过病理生理学及高危因素的分析,介绍预防与治疗方法.通过补液、补充白蛋白、经阴道腹水穿刺术等综合治疗是一种新方法.     

护理干预对妊娠期糖尿病患者妊娠结局的影响

妊娠期糖尿病是指妊娠期发生或首次发现的糖尿病,常伴有明显的代谢紊乱,发病率为1%～5%[1]。妊娠期糖尿病属高危妊娠,是妊娠期常见的并发症,如得不到及时治疗,可出现一系列并发症及合并症,如孕妇可发生酮症酸中毒、妊娠期高血压疾病（妊高病）、感染和羊水过多等;也可出现巨大儿、死胎、早产、     

糖尿病酮症酸中毒临床48例诊治分析

目的：探讨糖尿病酮症酸中毒（DKA）的救治方案。方法：回顾性分析本院2009年10月至2011年6月收治的48例DKA患者的临床资料。结果：26例DKA患者主要诱因是感染,9例自己停用胰岛素,2例妊娠,7例是饮酒及饮食过多,4例无明显诱因,经治疗均得到纠正,血糖控制良好,经2～4周调整治疗治愈出院。结论：早期诊断,及时应用胰岛素治疗、补液是DKA抢救成功的关键。     

糖尿病酮症酸中毒20例临床分析

目的：探讨糖尿病酮症酸中毒（DKA）患者的临床特点、诊断、治疗。方法：对我院2006—2009年住院的20倒DKA患者的临床发病特点、临床表现、实验室检查、诊断及沟通进行回顾性分析。结果：20例患者血糖均降至6．2—10．6mmoL／L,尿糖转阴,尿酮体消失,电解质恢复正常,全部痊愈出院。结论：DKA是糖尿病常见的急性并发症,是可以预防及逆转的危泉,早期诊断,及时合理治疗是关键。     

妊娠合并糖尿病酮症酸中毒的识别和处理

妊娠合并糖尿病酮症酸中毒是产科严重的合并症,如未能及时诊断及处理,会造成母儿严重的不良结局。本文就妊娠合并DKA的临床识别及处理进行讨论。     

妊娠合并糖尿病并发酮症酸中毒临床处理

文章介绍了妊娠合并糖尿病并发酮症酸中毒的发病诱因和诊断，主要阐明了治疗酮症酸中毒的关键：合理补液，静脉胰岛素滴注降低血糖，纠正电解质紊乱，恰当的产科处理是降低母儿不良结局的重要措施。     

Diabetic ketoacidosis in pregnancy

Episodes of diabetic ketoacidosis (DKA) can represent a life-threatening emergency for mother and fetus. The cornerstones of treatment of DKA are aggressive fluid replacement and insulin administration while ascertaining which precipitating factors brought about the current episode of DKA, and then treating accordingly to mitigate those factors. The incidence of DKA and factors unique to pregnancy are discussed in this article, along with the effects of the disease process on pregnancy. Clinical presentation, diagnosis, and treatment modalities are covered in detail to offer ideas to improve maternal and fetal outcome.     

Ketoacidosis in diabetic pregnancy

Diabetic ketoacidosis (DKA) is a serious medical and obstetrical emergency previously considered typical of type 1 diabetes but now reported also in type 2 and GDM patients. Although it is a fairly rare condition, DKA in pregnancy can compromise both fetus and mother. Metabolic changes occurring during pregnancy predispose to DKA in fact it can develop even in setting of normoglycemia. This article will provide the reader with information regarding the pathophysiology underlying DKA, in particular euglycemic DKA, and will provide information regarding all possible effects of ketones on the fetus.     

妊娠期糖尿病酮症酸中毒的预测及预警

妊娠期糖尿病酮症酸中毒是一种少见但却潜在威胁母儿生命安全的疾病。多见于1型糖尿病合并妊娠的患者,也可见于2型糖尿病合并妊娠患者和妊娠期糖尿病患者。对妊娠期糖尿病酮症酸中毒进行早期的识别和诊断,对改善母儿结局意义重大。文章就妊娠期糖尿病酮症酸中毒的病理生理、对母儿的影响、诱发因素、预测因子、早期预警信号及预测模型等进行论述。     

Diabetes ketoacidosis in pregnancy

Diabetic ketoacidosis (DKA) is a serious medical and obstetrical emergency usually occurring in patients with type 1 (insulin-dependent) diabetes mellitus. Although modern management of the patient with diabetes should prevent the occurrence of DKA during pregnancy, this complication still occurs and can result in significant morbidity and mortality for mother and/or fetus. Metabolic changes occurring during pregnancy can predispose a pregnant diabetic to DKA. The diagnosis of DKA can be more challenging during pregnancy as it does not always manifest with the classic presenting symptoms or laboratory findings. In fact, although uncommon, during pregnancy, DKA may develop even in the setting of relative normoglycemia. Prompt diagnosis and management is essential in order to optimize maternal and fetal outcomes. This article will provide the reader with information regarding the pathophysiology underlying DKA complicating pregnancy and will provide practical management guidelines for the diagnosis and management of this condition.     

Diabetic ketoacidosis in pregnancy tends to occur at lower blood glucose levels: case-control study and a case report of euglycemic diabetic ketoacidosis in pregnancy.

Background and Objective: The occurrence of diabetic ketoacidosis (DKA) during pregnancy is considered a medical emergency. The aims of the present study were to evaluate the incidence of DKA in pregnant and non-pregnant women with diabetes; to compare the blood glucose levels at the diagnosis of DKA in pregnant and non-pregnant women; and to show a case of euglycemic DKA in pregnancy. Methods: The subjects consisted of 90 cases of DKA in pregnant women with diabetes and 286 cases of non-pregnant female inpatients receiving treatment for diabetes during 2001 to 2005 in our hospital. The incidence of DKA in pregnant and non-pregnant women with diabetes and the blood glucose levels at the diagnosis of DKA in pregnant and non-pregnant women were compared. Results: DKA had a higher incidence in pregnant women with diabetes (8/90, 8.9%) than in non-pregnant women with diabetes (9/286, 3.1%) (P < 0.05). The blood glucose levels (mmol/L) in pregnant women with DKA were significantly lower than those in non-pregnant women with DKA (16.3 +/- 4.6 vs 27.5 +/- 4.8, P < 0.001). A case of euglycemic DKA in pregnancy was described whose serum glucose level was only 6.9 mmol/L. Conclusions: DKA in pregnant women with diabetes may occur more frequently, and at lower blood glucose levels than DKA in non-pregnant women with diabetes.     

Insulin-Dependent Diabetes Mellitus Presenting as Diabetic Ketoacidosis in Pregnancy

Summary: We report the cases of 2 pregnant women who developed diabetic ketoacidosis (DKA) in the third trimester as the first presentation of diabetes mellitus; both cases were associated with intrauterine fetal death.     

Clinical variables associated with diabetic ketoacidosis during pregnancy.

A retrospective review was conducted of all women with diabetic pregnancies admitted in diabetic ketoacidosis (DKA) to hospitals affiliated with the State University of New York at Buffalo between 1980 and 1990. The experience was combined with a literature review of similar patients described between 1970 and 1990, for a total of 37 admissions for DKA during pregnancy. Emesis and the use of beta-sympathomimetic drugs were considered etiologic in 57% of cases, while patient noncompliance and physician management errors were considered etiologic in 24% and contributory in 16%. Thirty percent of patients admitted with emesis had a prepregnancy history of diabetic gastroenteropathy, thus identifying that group as at particularly high risk for DKA. In the context of modern management, the causes of DKA in pregnancy are related uniquely to pregnancy, and the disorder is largely preventable during pregnancy.     

Diabetic ketoacidosis in pregnancy tends to occur at lower blood glucose levels: Case–control study and a case report of euglycemic diabetic ketoacidosis in pregnancy

Background and Objective:  The occurrence of diabetic ketoacidosis (DKA) during pregnancy is considered a medical emergency. The aims of the present study were to evaluate the incidence of DKA in pregnant and non-pregnant women with diabetes; to compare the blood glucose levels at the diagnosis of DKA in pregnant and non-pregnant women; and to show a case of euglycemic DKA in pregnancy.
Methods:  The subjects consisted of 90 cases of DKA in pregnant women with diabetes and 286 cases of non-pregnant female inpatients receiving treatment for diabetes during 2001 to 2005 in our hospital. The incidence of DKA in pregnant and non-pregnant women with diabetes and the blood glucose levels at the diagnosis of DKA in pregnant and non-pregnant women were compared.
Results:  DKA had a higher incidence in pregnant women with diabetes (8/90, 8.9%) than in non-pregnant women with diabetes (9/286, 3.1%) ( P  < 0.05). The blood glucose levels (mmol/L) in pregnant women with DKA were significantly lower than those in non-pregnant women with DKA (16.3 ± 4.6 vs 27.5 ± 4.8, P  < 0.001). A case of euglycemic DKA in pregnancy was described whose serum glucose level was only 6.9 mmol/L.
Conclusions:  DKA in pregnant women with diabetes may occur more frequently, and at lower blood glucose levels than DKA in non-pregnant women with diabetes.