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目的观察糖尿病酮症酸中毒合并急性胃粘膜病变治疗前后的变化。方法对34例糖尿病酮症酸中毒(DKA)合并急性胃粘膜病变患者进行内镜检查,并对其中的23例患者於内镜直视下取病变部位活组织进行病理学检查。结果 34例患者中食道、胃、十二脂肠粘膜充血、水肿、糜烂、出血26例(占76%)。23例病理学检查均为粘膜炎性改变,有炎症活动达100%。经控制高血糖、纠正代谢紊乱后二周复查内镜,21例中有17例(81%)胃粘膜的急性糜烂、出血性改变消失,4例明显好转。结论 DKA并急性胃粘膜病变累及范围广,病变弥漫且以粘膜为著。其发病与严重高血糖和代谢性酸中毒明显相关,胃粘膜的急性病变可随高血糖和代谢紊乱纠正而迅速好转。
Objective To observe the changes of diabetic ketoacidosis with acute gastric mucosal lesions before and after treatment. Methods Thirty-four patients with diabetic ketoacidosis (DKA) complicated with acute gastric mucosal lesions underwent endoscopic examination. Twenty-three of the patients underwent pathological examination of the diseased parts under endoscopy. Results Among the 34 patients, 26 cases (76%) had hyperaemia, edema, erosion and hemorrhage in esophageal, gastric and duodenal mucosa. 23 cases of pathological examination were mucosal inflammatory changes, there are 100% of inflammatory activity. Controlled by hyperglycemia, to correct the metabolic disorder two weeks after the review of endoscopy, 21 cases of 17 cases (81%) of acute gastric mucosal erosion, bleeding disappeared, 4 cases were significantly improved. Conclusion DKA and acute gastric mucosal lesions involving a wide range of lesions diffuse mucosa. The incidence of severe hyperglycemia and metabolic acidosis was significantly related to acute gastric mucosal lesions with hyperglycemia and metabolic disorders can be quickly corrected.