论文部分内容阅读
患儿,女,13岁,因烦渴多尿1月,恶心呕吐2天急诊入院,6年前确诊肾病综合征,服用强的松治疗(10～60mg/日),未曾出现过糖尿,90年8月第7次住院,考虑肾病多次复发,将强的松增量至120mg/日,加量前4次尿糖检查(-),加量第10天,血压由16/11kPa,增至24/16kPa,又将强的松减至90mg/日,加用降压药,此时尿糖+++,尿量较平日增多,未介意,带药出院治疗,继服强的松90mg/日,4周后减量为70mg/日,此期间多饮多尿日趋明显,频繁呕吐、恶心,精神萎糜,于10月20日第8次入院,化验:尿蛋白(-),尿酮体+++,尿糖+++,血糖20mmol/L,CO_2CP15.96mmol/L,血K~+3mmol/L,Na~+126mmol/L,Cl~-90mmol/L,诊断为类固醇糖尿病,酮症酸中毒,电解质紊乱,经逐渐减少激素用量,加用胰岛素,
Child, female, 13 years old, polydipsia and polydipsia due to polydipsia in January, nausea and vomiting 2 days Emergency hospitalization, diagnosis of nephrotic syndrome 6 years ago, taking prednisone (10 ~ 60mg / day), had no diabetes, 90 In August of the seventh hospitalization, consider multiple relapse of kidney disease, the prednisone increased to 120mg / day, plus the first four urine tests (-), plus the first 10 days, blood pressure by 16 / 11kPa, by To 24 / 16kPa, and then reduced to prednisone 90mg / day, plus antihypertensive drugs, urine +++ at this time, urine volume increased more than usual, did not mind, with medicine discharge treatment, following the strong prednisone 90mg / Day, 4 weeks after the reduction of 70mg / day, this period of drinking polyuria increasingly obvious, frequent vomiting, nausea, spiritual wilt, on the 20th of October 8th admission, urine protein (-), urine ketone bodies +++, urine +++, blood glucose 20mmol / L, CO_2CP15.96mmol / L, blood K +3mmol / L, Na +126mmol / L, Cl- -90mmol / L, diagnosed as steroid diabetes, ketosis Acidosis, electrolyte imbalance, by gradually reducing the amount of hormones, plus insulin,