糖尿病并发多器官功能衰竭64例临床分析

目的 分析糖尿病并发多器官功能衰竭的诱因、临床表现及诊治方法.方法 回顾性分析64例糖尿病并发多器官功能衰竭患者的临床资料,统计分析其发病原因、累积器官、发病率及病死率等.结果 64例患者中,衰竭器官为心脏64例(100.0％)、肾脏59例(92.2％)、脑21例(32.8％)、肺脏9例(14.1％)、胃肠道2例(3.1％)、肝脏1例(1.6％).血糖≥33.5 mmol/L组发生多器官功能衰竭37例(57.8％),明显高于12.2 ～ 22.4 mmol/L组和22.5 ～ 33.4 mmol/L组的8例(12.5％)、19例(29.7％)(x2=28.82、10.285,均P＜0.05),22.5～ 33.4 mmol/L组也明显高于12.2 ～ 22.4 mmol/L组(x2=5.67,P＜0.05).引起多器官功能衰竭的诱因为感染49例(76.6％)、自行停药6例(9.4％)、酮症酸中毒5例(7.8％)、心脑血管意外4例(6.3％).结论 在糖尿病早期积极控制血糖,防止并发症,及时消除诱因,减少多器官功能衰竭的发生,能够有效地降低其病死率.

Clinical analysis of 64 cases of diabetes complicated with multiple organ failure

Objective To analyze the inducement, clinical manifestations, diagnosis and treatment of diabe- tes patients with multiple organ failure（MOF）. Methods A retrospective analysis of 64 diabetes patients with multi- ple organ failure was executed ,the clinical data were statistically analyzed. Results Heart failure was the most com- mon in 64 cases with a incidence of 100.0% ,the rest common failure organ were kidney（92.2% ） ,brain（32.8% ） , lung（ ld. 1% ） ,gastrointestinal tract（3.1% ）, and liver（ 1.6% ）. Cases with the glucose level over 33.5mmol/L illus- trated a significantly higher incidence than other groups （ P 〈 O. 05 ）, glucose level between 22.5 and 33.4mmol/L group was significantly higher than the 12.2 - 22.4mmol/L group（ P 〈 0.05） The inducement of MOF were infection （76. 6% ） medicafier~ terminate （ 9. 4% ）, ketoacidosis （ 7. 8% ）, cardiovascular and cerebrovascular accidents （6. 3% ）. Conclusion Positive control of blood glucose in the early stage of diabetes, prevent complications, elimi- nate the incentive could reduce the incidence of MOF, eventually reduce the mortality rate.