5岁以下1型糖尿病患儿21例

目的探讨5岁以下婴幼儿糖尿病的临床特点、诊断及酮症酸中毒(DKA)的抢救措施。方法回顾性分析21例5岁以下婴幼儿糖尿病患儿的发病情况、临床特点、误诊情况,并探讨急救治疗体会。结果婴幼儿糖尿病临床症状不典型,糖尿病自身抗体阳性率低,初诊误诊率达52.4%,DKA发生率也高达52.4%。感染是诱发DKA的常见原因,患儿无1例死亡,1例放弃治疗,出院后治疗依从性不一。结论婴幼儿糖尿病多为特发性,临床症状不典型,易误诊、漏诊。感染可能导致患儿糖尿病的进展和临床表现出现。小剂量胰岛素持续静滴、调节酸碱平衡和纠正电解质紊乱是急救的关键。

Twenty - One Cases of Type 1 Diabetes under 5 Years Old

Objective To explore the clinical characteristics and emergency treatment for type 1 diabetes(T1DM) and diabetes ketoacidosis(DKA) in children under 5 years old.Methods Twenty-one children under 5 years old with T1DM with 10 years were retrospecti-vely reviewed.The onset situation,clinical feature and treatment of DKA were analyzed.Results The cases of little children diabetes might not have typical symptoms.The positivity of islet antibody was lower.High morbidity of DKA was found in little children and DKA was often caused by infection.Conclusions Infection may be involved in the onset and progress of childhood T1DM.Emergency treatment for DKA may involve the injection of small dose insulin,correction of the disorder of water and electrolysis and regulation of acid-base.