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在治疗儿科糖尿病酸性酸症期间,高血症和长期酸性病
Didem Yıldırımçakar1, Murat Öcal, Selda Ayça Altıncık
1From the Department of Pediatric Endocrinology, Pamukkale University, Denizli, Turkey.
Pediatric emergency care
|September 30, 2024
概括
在糖尿病酸性 (DKA) 治疗期间,高血症经常发生,可能会延长酸性. 监测阳离子间隙和化物水平可以帮助区分DKA和高化代谢酸性化症 (HMA).
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 糖尿病酸症 (DKA) 是糖尿病的一种严重并发症,其特征是代谢性酸症.
- 对DKA进行静脉输液治疗可能会导致由于过载而导致高性代谢酸症 (HMA).
- 即使在血症消失后,HMA也可能持续存在,这使得DKA的管理变得复杂.
研究的目的:
- 调查DKA治疗期间高血症的发生率和时间.
- 评估高血症对DKA患者酸性溶解的影响.
- 确定在治疗期间区分DKA和HMA的方法.
主要方法:
- 在153名患者中对178次DKA发作进行了回顾性分析.
- 在多个时间点 (0-24小时) 评估静脉血液气体参数,离子间隙和化物水平.
- 患有高血症和没有高血症的患者之间的酸参数的比较.
主要成果:
- 在69.3%的患者中检测到高血症,通常在治疗后6.3小时左右发生.
- 高血的发生率随着治疗持续时间的增加而增加.
- 患有高血症的患者表现出更严重的酸性化症,更高的HbA1c和延长的分辨时间,标准参数显示持续的酸性化症比校正的措施更长.
结论:
- 高血是DKA治疗期间的常见并发症.
- 常规监测阳离子间隙,血和Cl-/Na+比率可以帮助区分DKA和HMA.
- 这些额外的监测策略可以防止长时间的静脉注射液治疗.
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