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find Keyword "糖尿病酮症酸中毒" 5 results
  • Clinical Analysis of 9 Cases of Obese Type Ⅱ Diabetes and Ketoacidosis Combined with Acute Pancreatitis

    目的:提高临床医师对以腹痛为首发症状的肥胖型2型糖尿病酮症酸中毒(DKA)并高脂血症(HL)性急性胰腺炎(AP)的认识。方法:回顾性分析我院2005年1月至2008年3月收治的9例肥胖型2型糖尿病酮症酸中毒并高脂血症性急性胰腺炎患者的临床资料。结果:(1)9例均为青年男性,年龄30.78±5.56岁;(2)病前均无糖尿病史及相关症状,均无高脂血症史;(3)病前均无暴饮、暴食和胆石症史;(4)均以腹痛为首发症状,均有腹压痛;(5)均为肥胖体型,体质指数28.33±1.54 kg/m2;(6)均达到DKA诊断标准;(7)入院时有7例血淀粉酶升高,其中6例超过正常值3倍以上,2例正常(其中1例入院后升高达正常值3倍以上);(8)入院时均有高脂血症,其中3例脂血,6例TG均gt;113 mmol/L,DKA纠正后(入院后第3天)TG降至1.1~1.8 mmol/L,TC降至3.6~4.6 mmol/L;(9)B超或CT均有胰腺炎改变;(10)治愈后症状解除,血TG、TC均正常或稍高,血尿淀粉酶均正常。结论:(1)以腹痛就诊的DKA患者,应常规查TG、TC、血尿淀粉酶、胰腺B超或CT,以排除高脂血症性胰腺炎;(2)青年肥胖型2型糖尿病可能以糖尿病酮症酸中毒并高脂血症性急性胰腺炎为首发表现入院。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • 糖尿病酮症酸中毒横纹肌溶解致急性肾功能衰竭一例

    【摘要】 目的 报道糖尿病酮症酸中毒(DKA)横纹肌溶解(RM)并致急性肾功能衰竭的临床诊治经验。〖HTH〗方法〖HTSS〗 2009年10月8日收治1例DKA患者,病程中出现意识障碍、RM、急性肾功能衰竭,行连续性血液净化治疗。结果 48 h后患者意识障碍恢复,血肌酸激酶下降,酸中毒纠正,治疗效果显著。结论 提高对DKA患者发生RM的认识和常规肌酶谱的动态监测,做好早期诊断以及预防极其重要,是RM合并急性肾损伤(AKI)治疗的关键,有利于提高糖尿病患者的生存率。

    Release date:2016-09-08 09:37 Export PDF Favorites Scan
  • 糖尿病酮症酸中毒合并高甘油三酯血症、急性胰腺炎13例临床分析

    目的:提高临床医师对糖尿病酮症酸中毒合并高甘油三酯血症及急性胰腺炎的认识。方法:回顾性分析13 例糖尿病酮症酸中毒合并高甘油三酯血症及急性胰腺炎的临床资料。结果:所有患者除有糖尿病酮症酸中毒的特征外,11例有腹痛,所有病例甘油三酯、血尿淀粉酶、脂肪酶均明显升高,CT检查胰腺均有改变,而超声检查仅有6例有改变;12 例治愈,1 例死亡。结论:对于有腹痛的糖尿病酮症酸中毒患者甘油三酯明显升高者应及时查淀粉酶及脂肪酶,必要时作腹部CT检查,以便能及时发现急性胰腺炎。

    Release date:2016-09-08 10:00 Export PDF Favorites Scan
  • Clinical Heterogeneity and Autoimmunity Profiles of Patients with Diabetic Ketosis or Ketoacidosis

    ObjectiveTo investigate the clinical heterogeneity and auto-immunologic state in patients with diabetic ketosis (DK) or diabetic ketoacidosis (DKA). MethodsDiabetic patients who presented with DK/DKA were recruited from West China Hospital of Sichuan University from January 1, 2000, to December 31, 2008. We analyzed the clinical classification, biochemical profiles, and auto-immunologic state of the patients. ResultsAmong them, 257 (15.0%) patients had type 1 diabetes, while 883 (51.6%) with type 2 diabetes, and 515 (30.1%) could be typed as "atypical diabetes" or "untying diabetes". The average age of hospitalized patients with type 1 diabetes was (31.1±13.5) years, which was significantly lower than that of the type 2 diabetes patients [(58.1±13.2) years] (P<0.001). The most common contributing factor for DK/DKA was infection, followed by noncompliance with therapy. Glutamic acid decarboxylase antibody positive rate was 4.37% in patients with "atypical diabetes", which was similar with type 2 diabetes group (2.69%, P=0.79), but lower than that of the patients with type 1 diabetes (13.79%, P<0.001). ConclusionsWe conclude that DK or DKA can occur not only in type 1 diabetic patients but also in patients with type 2 diabetes under infection or stress condition. DK/DKA patients have a high clinical heterogeneity. The auto-immunologic state and β-cell function have significant implications for the diagnosis and classification of diabetes.

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  • Continuous renal replacement therapy for special types of acidosis

    Continuous renal replacement therapy (CRRT) is a term of blood purification technique that can continuously remove the body's solute and water for 24 hours without any interruption throughout each day. It has several advantages such as hemodynamic stability, accurate capacity control, stable internal environment, and inflammatory regulation, which is especially suitable for patients with severe hemodynamic instability. In clinical practice, critically ill patients treated with CRRT are often associated with different types of acidosis, including metabolic acidosis, lactic acidosis, citrate acidosis, ketoacidosis and hypercapnic acidosis. Different types of acidosis can be treated in different ways. This paper reviews the CRRT for special types of acidosis.

    Release date:2018-07-27 09:54 Export PDF Favorites Scan
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