论文部分内容阅读
目的探讨以酮症酸中毒起病的糖尿病患儿的病例特点,提高早期诊断率。方法对2000-01-2010-01陕西省靖边县人民医院儿科收治的以酮症酸中毒起病的23例进行回顾性分析。结果 23例患儿初诊时误诊为中枢神经系统感染者5例;误诊为急性胃肠炎、肺炎、中毒性菌痢各4例;误诊为败血症、急性阑尾炎、药物中毒各2例。结论对进食不当出现腹痛、呕吐且经常规治疗后出现乏困、嗜睡者;原因不明的意识障碍、酸中毒、脱水、休克且尿量仍多者应考虑糖尿病酮症酸中毒可能。耐心细致询问病史及体格检查是降低误诊率的关键。
Objective To investigate the characteristics of cases of diabetic patients with ketoacidosis and to improve the early diagnosis rate. Methods A retrospective analysis of 23 cases with ketoacidosis admitted to Pediatrics of Jingbian People ’s Hospital of Shaanxi Province from January 2000 to October 2010 was retrospectively analyzed. Results 23 cases were misdiagnosed as central nervous system infection in 5 cases; misdiagnosed as acute gastroenteritis, pneumonia, toxic bacillary dysentery in 4 cases; misdiagnosed as sepsis, acute appendicitis, drug poisoning in 2 cases. Conclusions Improper eating can lead to abdominal pain and vomiting, and the symptoms of diabetic ketoacidosis should be considered when there is sleepiness and lethargy after routine treatment. However, people with unconscious disturbance of consciousness, acidosis, dehydration, shock and excessive urine output should consider diabetic ketoacidosis. Being patient and careful about history and physical examination is the key to reducing the rate of misdiagnosis.