儿童糖尿病酮症酸中毒20年回顾分析

目的 探讨降低儿童糖尿病酮症酸中毒（DKA）的发病率、提高儿科治疗DKA的成功率的方法。方法 回顾分析了20年胰岛素依赖型糖尿病住院儿童114例（其中DKA53例）的资料。，结果 1999-2004年和1985-1991年或1992-1998年比较，DKA发病率明显下降（P〈0．05），年龄越小，DKA发病率越高，父母文化程度低的农村儿童发病率明显高于城镇儿童。DKA的诱因中，感染列首位（49．1％），停用胰岛素其次（20．8％），减少使用碳酸氢盐量的一组，其代谢恢复及住院时间均较剂量较大的两组明显缩短（P〈0.05）。结论 加强小儿糖尿病管理力度非常重要。较大剂量碳酸氢盐对治疗DKA有潜在的不利影响。

A retrospective analysis of children with diabetic ketoacidosis (DKA) in 20 years.

Objective To reduce the incidence of diabetic ketoacidosis(DKA) and improve the therapeutic efects of DKA in children.Methods One hundred and fourteen children with insulin dependent diabetes mellitus(IDDM),including 53 children with DKA treated during 20 years were retrospectively analysed.Results The incidence of DKA in children with diabetes decreased significantly during 1999-2004 as compared with 1985-1991 or 1992-1998(P<0.05).The younger was the child,the higher was the DKA incidence.The incidence of DKA of children in rural areas whose parents got less education was significantly higher than that of children in urban areas.Infection was the most common precipitating factor of DKA(49.1%),followed by the withdrawal of the insulin(20.8).The group with reduced NaHCO3 use recovered more quickly than the other two groups(P<0.05).Conclusion It is important to strengthen the management of children with diabetes.A higher dose of NaHCO3 is a potential disadvantage to the DKA.