糖尿病酸性脂肪酸症的错误诊断:一个病例报告
Minghe Zhang1, Jian Li2, Lianhui Fan1
1General Hospital of Northern Theater Command, Shenyang, China.
Journal of medical case reports
|August 16, 2025
概括
糖尿病酸性脂肪酸症可以引起仿效尿路结石的腹痛. 对于糖尿病患者来说,及时诊断至关重要,以预防严重并发症并确保有效的治疗,避免误诊.
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.
- 胃肠病学 胃肠病学
背景情况:
- 糖尿病酸症 (DKA) 很少引起腹痛,往往导致误诊为尿管结石.
- 在糖尿病患者中延迟识别DKA可能会导致危及生命的并发症.
- 这一案例强调了在成像表明其他原因的诊断挑战.
研究的目的:
- 要突出区分DKA诱导的腹痛与尿管石疼痛的重要性.
- 为了强调在糖尿病患者中考虑DKA的必要性,糖尿病患者有无法解释的腹痛.
- 通过识别重叠的症状来提高诊断准确度和患者的结果.
主要方法:
- 一个病例报告,一名59岁的女性患有持续的腹痛,最初被诊断为左尿管结石.
- 最初的成像显示出尿道石头和水,导致支架放置.
- 通过实验室测试证实了糖尿病酸性脂肪酸症,尽管传统治疗,但疼痛仍然存在.
主要成果:
- 尽管输入尿路支架和标准疼痛管理,患者的腹部疼痛仍然存在.
- 实验室测试证实糖尿病酸性作为腹痛的原因.
- 对DKA的全身治疗使代谢参数正常化,导致患者康复.
结论:
- 腹部疼痛机制和治疗方法在DKA和尿路结石之间存在显著差异.
- 临床医生必须考虑在糖尿病患者中使用DKA,这些糖尿病患者的腹痛对尿管石治疗无反应.
- 及时的临床评估和实验室测试对于准确的DKA诊断至关重要,避免治疗延迟和改善结果.
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