糖尿病酮症酸中毒34例抢救分析

目的探讨糖尿病酮症酸中毒（DKA）的发生、诱因、诊疗及死因临床特点。方法回顾分析34例DKA患者的临床资料。结果31例救治成功，死亡3例，死亡率8．9％。方法各年龄组均有发生，多为1型糖尿病（82％），一半以上DKA病人（53％）无糖尿病史，有7例以昏迷（21％）及5例以腹痛（15％）就诊，所以对昏迷及腹痛的患者要除外DKA，避免漏诊和误诊。DKA的主要诱因为感染（73％）。在补液、胰岛素使用、纠正酸中毒及电解质紊乱救治过程中要动态观察和及时调整，通过规范治疗，大部分病人（91％）代谢紊乱得到纠正，对急性脑水肿、急性呼吸窘迫综合征（ARDS）等主要死因要及早预防处置。

Salvage analysis of diabetic ketoacidosis in 34 cases

Objective To explore the inducement,diagnosis,therapy and death causes of diabetic ketoacidosis（DKA）. Methods Retrospective analysis of 34 cases of DKA. Results 31 cases were all right after salvage 3 cases were dead,the mortality was 8.9% .Conclusions DKA may occur in every age phase,but most in the young of type 1 DM （82%）. More than half of the cases （53%） without DM,7 cases （21%）saw doctor for coma and 5 cases （15%） for bellyache, so be thinking about DKA to the cases of coma or bellyache were good for fight diagnosis. The main inducement of DKA were infection （73%）. Regularity treatment include transfusion ,insulin usage, adiustion the acidosis and turbulence of electrolyte, most of metabolic tutbulence got back （91% ）. Acute, cerebral edema and acute respiratory distress syndrome （ARDS）were main death causes, must be prevent and treatment in time.