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自胰岛素临床应用以来,糖尿病酸中毒(DKA)死亡率显著下降。但是,以往采用大剂量胰岛素疗法,既缺乏足够的生理学和药理学的理论基础,又易引起低血糖、低血钾、低血磷、低血镁以及内环境平衡失调和脑水肿等综合征。七十年代以后,应用小剂量胰岛素治疗 DKA,通过临床观察证明,其效果稳定,易于掌握,值得临床推荐。一、胰岛素应用剂量的回顾小剂量胰岛素治疗 DKA,并非近期开始。1921年班廷(Banting)和贝斯特(Best)发现胰岛素的初期,即是小剂量应用。1923年福斯特(Foster)报告了用胰岛素治疗15例糖尿病患者,12小时内用量为180单位,其中1例仅每小时5单位,而病情得以恢复。直到1945年,鲁特(Root)应用大剂量胰
Diabetic acidosis (DKA) mortality has dropped significantly since the clinical use of insulin. However, in the past, the use of high-dose insulin therapy not only lacked sufficient theoretical basis for physiology and pharmacology, but also easily caused hypoglycemia, hypokalemia, hypophosphatemia, hypomagnesemia, and disorders of homeostasis and brain edema syndrome. After the seventies, the application of small doses of insulin treatment of DKA, clinically proven, the effect is stable, easy to master, is worth clinical recommendation. First, the review of insulin dose Dose of insulin treatment of DKA, not the recent start. In 1921 Banting and Best discovered the initial phase of insulin, which was a low-dose application. 1923 Foster reported 15 patients with diabetes treated with insulin, 180 units within 12 hours, of which 1 case only 5 units per hour, and the condition recovered. Until 1945, Root used high-dose pancreatic juice