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患有高血糖症的患者的酸和电解质障碍:一个单心的观察性研究
Christoph Schwarz1, Fabian Ruttinger2, Georg-Christian Funk3,4
1Department of Internal Medicine 1, Cardiology, Nephrology, and Intensive Care, Pyhrn-Eisenwurzenklinikum Steyr, Steyr, Austria.
严重的高血糖症经常涉及复杂的酸和电解质失衡. 目前用于糖尿病酸性脂肪酸症和超小胞性高血糖状态的诊断方法可能会忽略这些综合性疾病,影响患者的护理.
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:
- 急性高血糖症通常伴有显著的酸和电解质干扰.
- 现有的高血糖紧急情况的诊断标准通常依赖于有限的参数,如pH值,血清二碳酸盐和离子间隙.
- 这项研究调查了严重高血糖症中复杂的酸性疾病的患病率.
研究的目的:
- 为了确定各种酸和电解质疾病的患病率在患有严重高血糖症的患者中.
- 评估当前诊断标准在识别复杂的酸性疾病方面的局限性.
- 评估这些疾病和血清度对患者死亡率的影响.
主要方法:
- 对1159次严重高血糖症发作进行了回顾性分析.
- 在入院时测量动脉血液气体,血清电解质和度.
- 在入院后7天内对患者结果的评估.
主要成果:
- 超过90%的患者患有酸性疾病,混合性疾病是最常见的 (75%).
- 血清度升高和电解质失衡显著与较高的死亡率有关.
- 没有电解质障碍的患者的死亡率要低得多 (2%).
结论:
- 严重的高血糖症经常与复杂的酸和电解质疾病有关.
- 目前用于糖尿病酸性酸症 (DKA) 和超的高血糖状态 (HHS) 的诊断标准可能无法充分解决联合酸干扰.
- 如果不识别这些复杂的疾病,可能会对患者的治疗和结果产生负面影响.
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