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小婴儿 1型糖尿病较少 ,儿科临床医生多缺乏诊断和治疗经验 ,往往因延误诊断和处理不当而加重病情 ,如因脱水酸中毒给输入含糖液而加重了病情 ,或因纠正酸中毒和对血糖水平很高的小婴儿治疗过于积极 [胰岛素小剂量持续静点 ,1岁以下婴儿用量应为 0 .0 5 U/ (kg· h) ],使血糖急剧下降 ,或纠正酸中毒用 5 %碳酸氢钠直接滴入 ,用量过急过大易造成碱中毒和脑内酸中毒进一步加重而死亡。对于病情极为严重者抢救治疗应缓慢细致。多次评估血糖、电解质和血气 ,均使其缓慢纠正并恢复 ,反而较容易抢救生命。本期发表 2例婴儿糖尿病酮症酸中毒死亡病例 ,希望吸取教训并引起临床对小婴儿糖尿病诊断和治疗的重视。
Small infants less type 1 diabetes, pediatric clinicians lack of diagnosis and treatment experience, often due to delay diagnosis and improper handling and aggravate the condition, such as dehydration acidosis to the input of sugary fluid aggravated the condition, or due to correct acidosis and The treatment of infants with very high blood sugar levels is too aggressive [low doses of insulin at a steady-state, with a dose of 0,05 U / (kg • h) for infants under 1 year of age], resulting in a sharp drop in blood glucose or correcting for acidosis % Sodium bicarbonate direct instillation, the amount of too rapid too easy to cause alkali poisoning and brain acidosis further aggravate and die. Severe illness for the rescue treatment should be slow and meticulous. Repeated assessment of blood glucose, electrolytes and blood gas, make it slowly corrected and restored, but easier to save lives. This issue of 2 cases of infant deaths caused by diabetic ketoacidosis, hoping to learn the lessons and cause clinical diagnosis of small infants and the importance of treatment.