DKA

摘要： 目的观察中西医结合治疗糖尿病酮症酸中毒(DKA)的临床效果,并研究其治疗机制。方法选择邹城市中医院2020年6月—2021年12月收治的89例DKA患者作为研究对象,运用电脑数字分组法分为对照组(44例)与研究组(45例)。对照组患者接受常规西医疗法,研究组在西医治疗基础之上自拟滋阴补气方进行治疗,比较两组患者临床指标的恢复时间、中医证候评分以及血气指标。结果研究组患者的血糖达标、尿酮体转阴、酸中毒纠正所用时间均显著低于对照组,差异有统计学意义(P<0.05)。研究组患者中医证候积分显著低于对照组,差异有统计学意义(P<0.05)。治疗1周后研究组患者血气分析及实验室各指标水平显著优于对照组,差异有统计学意义(P<0.05)。结论对糖尿病酮症酸中毒患者在西医治疗基础之上接收滋阴补气方进行治疗,其患者的临床症状改变速度、中医证候积分以及各生化指标变化情况均显著改善,中西医结合方案治疗糖尿病酮症酸中毒效果显著。

摘要： 目的:探讨普通胰岛素联合诺和锐在糖尿病酮症酸中毒(DKA)中的临床效果.方法:将2017年3月-2019年3月收治的60例DKA患者按照治疗方式分为对照组(普通胰岛素治疗;30例)与观察组(普通胰岛素联合诺和锐治疗,30例),对比其临床效果.结果:观察组患者所用的尿酮转阴时间及纠正酸中毒时间均明显短于对照组患者,且尿酮体转阴后胰岛素用量也明显更少,差异均较为显著(P<0.05);此外,观察组患者的低血糖发生率明显低于对照组患者(P<0.05).结论:普通胰岛素联合诺和锐在DKA患者的治疗中具有更为显著的临床效果,其高效性及安全性均较为理想.

摘要： 目的 分析个体化饮食管理联合人文护理对糖尿病酮症酸中毒(DKA)患者酮体水平、生活质量的影响.方法 简单随机选取该院收治的50例2018年1月—2019年8月DAK患者作为研究对象,随机分为对照组(基本护理,n=25)、研究组(个体化饮食管理联合人文护理,n=25),比较两组间血糖恢复正常、血酮恢复正常、总住院时间,生活质量评分(SF-36),以及并发症发生率.结果 干预后,研究组血糖恢复正常、血酮恢复正常、总住院时间分别为(5.56±0.54)d、(16.67±1.56)h、(9.12±1.01)d均短于对照组,差异有统计学意义(t=13.545、19.167、9.187,P<0.05);研究组SF-36各项评分均高于对照组,差异有统计学意义(P<0.05);研究组感染、急性肾损伤(AKI)、低钾血症、脑水肿总发生率为8.00％低于对照组的32.00％,差异有统计学意义(P<0.05).结论 DKA患者为糖尿病严重并发症,住院期间实施个体化饮食管理联合人文护理可促进病情恢复,改善生活质量,降低并发症的发生.

摘要： 目的:探讨糖尿病酮症酸中毒(DKA)患者采用人文护理的效果及对并发症的影响.方法:将72例本院2019年2月-2020年5月收治的糖尿病酮症酸中毒患者作为研究对象,遵循随机原则分成两个研究小组,36例参照组患者运用基础护理,36例试验组患者运用人文护理,对比两组护理效果和并发症情况.结果:试验组症状缓解时间、酮体转阴时间、住院时间均短于参照组,差异呈统计学意义(P<0.05).试验组并发症发生率为8.33％、低于参照组的27.78％,差异呈统计学意义(P<0.05).结论:给予糖尿病酮症酸中毒(DKA)患者人文护理能有效提升康复效果,减少并发症,值得全方位推广.

摘要： 目的 探讨对糖尿病酮症酸中毒(DKA)患者采用胰岛素微泵持续皮下给药治疗的效果.方法 将2018年1月—2020年6月期间该院收治的DKA患者随机分成观察组和对照组,分别采用胰岛素微泵持续皮下和静脉持续给药治疗,观察生化和氧化应激指标的变化,疗效和药物不良反应.结果 治疗后,观察组的pH、HCO3-和β-HB等生化指标,SOD、GSH-PX和MDA等氧化应激指标均较治疗前和对照组显著改善,差异有统计学意义(P<0.05).观察组的血糖控制和血pH值恢复时间、胰岛素用量和低血糖发生率均显著低于对照组,差异有统计学意义(P<0.05).结论 对DKA患者采用胰岛素微泵持续皮下给药治疗,能显著改善生化和氧化应激指标,快速平稳控制血糖水平,提高用药安全性.

摘要： 目的:通过分析糖尿病酮症酸中毒(DKA)69例患者的临床资料,为医师临床诊疗DKA患者提供参考依据.方法:对住院治疗的69例DKA患者的临床资料进行回顾性分析.结果:69例DKA患者经积极诊断、足量补液及小剂量胰岛素持续静脉滴注等治疗后,59例患者病情治愈,治疗成功率85.51％,死亡10例,病死率14.49％.结论:早期诊断、大量补液、持续静脉应用小剂量胰岛素是DKA治疗成功的关键.

摘要： 目的:探讨糖尿病酮症酸中毒误诊为急腹症的原因与鉴别方法.方法:对8例DKA误诊为急腹症患者的治疗资料进行回顾性分析.结果:经过综合治疗后所有确诊患者均转入内分泌科继续治疗,在所有误诊患者中有2例误诊为急性胰腺炎、3例误诊为急性阑尾炎、3例误诊为急性肠胃炎.所有误诊患者在经过后续治疗后症状均有所好转,无患者出现死亡现象.同时,对8例DKA误诊为急腹症患者进行症状分析可知,所有被误诊的患者均存在腹膜刺激疼痛的症状,这与急腹症的临床症状相吻合.但是,患者的疼痛部位存在游走现象.结论:DKA易误诊为急腹症,其原因在于:医生的问诊不详细,体检流程不严格,对DKA患者提供的辅助检查不全面.提高对DKA的鉴别准确性是提高治疗效果与治疗安全性的重要保障,因此,在DKA的鉴别中应当把握其鉴别要点从而提高鉴别的准确性.

摘要： Aim: Review of presentation, management and outcome of patients admitted with Diabetic Ketoacidosis (DKA) to an emergency department short stay unit with expedited discharge. Methods: All admitted patients with a discharge diagnosis of “Diabetic Ketoacidosis”, were identified by the file auditing section in the Emergency Department. Data obtained from the medical records were collected using an explicit chart review from January 2012 to June 2013. Data included clinical monitoring, investigations performed, the type and amount of intravenous fluids given, the insulin regime, potassium supplementation and outcome. Results: Out of a total of 120 patients labelled as DKA or hyperglycaemia on arrival, hundred patients fulfilled the criteria for DKA. In the population studied the mean age was 25 years with a male predominance. Eighty-two patients suffered from Type 1 Diabetes Mellitus (T1DM) whilst eighteen patients had Type 2 Diabetes Mellitus (T2DM). Sixteen patients were newly diagnosed during the present admission. Seventy-six (76%) patients were on insulin. The insulin regimen and potassium supplementation were followed as per protocol in all patients. All the patients except one were given intravenous fluid according to protocol. Parameters were monitored adequately except fluid input and output monitoring. The median length of stay in the short stay unit was 1.5833 days. There was no return visit within one week of discharge. Conclusion: The median length of stay was short and there were no documented complications or deaths during the stay. There was poor compliance with documentation of fluid input and output. In this population, the short stay model of care appeared to be safe and efficient.

摘要： It has been well documented that acute pancreatitis and diabetic ketoacidosis (DKA) co-occur, and both of them present either as a cause or result of the other [1] [2]. Recently, hypertriglyceridemia has been reported to co-occur as well [3] [4];the involvement of acute adrenalitis in the setting of acute pancreatitis and DKA has not been reported. We report a case of sudden death due to diabetic ketoacidosis, acute pancreatitis and acute adrenalitis in a 37-year-old female. She was found unresponsive and breathless in bed by her mother at their residence. At the time of the autopsy, both lungs were expanded and sigmoid diverticulosis was discovered on gross examination. Histology of the pancreas and the adrenal glands revealed acute inflammation despite appearing normal upon gross examination. The postmortem toxicology report showed high levels of acetone (12 mg/dL) in the postmortem blood and extremely high levels of glucose (>500 mg/dL) in the postmortem vitreous fluid. This is the first reported case of fatal diabetic ketoacidosis co-occurring with acute pancreatitis and acute adrenalitis.

摘要： 目的 分析血清β-羟丁酸和尿酮体在DKA诊断中的价值对比.方法 选取我院收治32例患者糖尿病酮症酸中毒及32例糖尿病非酮体症酸中毒患者,检测两组参与者的血清β-羟丁酸和尿酮体的含量.结果 实验组阳性31例,阴性1例,阳性率是96.87％,对照组阳性23例,阴性9例,阳性率是71.87％,两组数据差异具有统计学意义(P＜0.05);实验组β-羟丁酸是(0.63±0.015) mmol/L,对照组β-羟丁酸是(0.19±0.073) mmol/L,两组数据差异具有统计学意义(P＜0.05).结论 糖尿病患者体内β-羟丁酸含量较高,有助于糖尿病早期发现与诊断,敏感性高于尿酮体,值得在临床上进一步推广使用.

摘要： 本发明公开了对映‑贝壳杉烷型二萜化合物DKA在制备抗肿瘤侵袭转移药物或抑制剂中的应用，本发明从豨莶草中分离得到对映‑贝壳杉烷型二萜化合物DKA，并通过transwell试验、划痕试验、小鼠乳腺癌肺转移等试验证实得到的对映‑贝壳杉烷型二萜化合物DKA没有细胞毒活性，可显著抑制细胞迁移，可以显著抑制MDA‑MB‑231乳腺癌细胞肺转移。具有显著的抗肿瘤转移作用，可以用于制备抗肿瘤侵袭转移的药物或抑制剂。