妊娠糖尿病酮症酸中毒临床特点及诱因分析  

Analysis of Clinical Characteristics and Causes of Diabetic Ketoacidosis of Diabetes Mellitus during Gestation

作　　者：吴琳琳[1] 李智泉[1] 

机构地区：[1]深圳市妇幼保健院,广东深圳518000

出　　处：《中外医学研究》2012年第14期17-20,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨妊娠糖尿病酮症酸中毒临床特点、诱因及对母儿的影响。方法:回顾性分析2010年1月-2011年10月笔者所在医院收治的7例妊娠糖尿病酮症酸中毒患者的临床资料。结果:(1)妊娠期糖尿病患者,酮症酸中毒的发生率为0(0/1872);妊娠合并糖尿病患者中,糖尿病酮症酸中毒的发生率21.88%(7/32),平均血糖水平(21.44±10.97)mmol/L。(2)7例妊娠糖尿病酮症酸中毒的诱因:①孕前未诊断糖尿病,孕早期未及时诊断或治疗,延及妊娠中晚期发生糖尿病酮症酸中毒,共4例(4/7,57.14%);②孕前已知糖尿病孕妇,妊娠血糖控制不佳,分别在出现妊娠期高血压综合征、使用糖皮质激素后发生娠期糖尿病酮症酸中毒,共2例(2/7,28.57%);③妊娠合并1型糖尿病,剖宫产术后因进食少而停用胰岛素两天后发生酮症酸中毒,共1例(1/7,14.29%)。(3)妊娠结局:无孕产妇死亡,围产儿死亡1例(1/7,14.29%),其余新生儿无窒息。结论:妊娠糖尿病酮症酸中毒,常发生在孕期血糖控制不良的妊娠合并糖尿病患者。Objective：To analyze the clinical characteristics,causes and effects of diabetic ketoacidosis（DKA） during gestation.Methods：Seven DKA patients during gestation were retrospectively analyzed from Jan 2010 to Oct 2011.Results：（1） The morbidity of DKA during GDM was 0（0/1872）,where as in pregnancy with diabetes mellitus,the DKA rate was 21.88%（7/32）.The average levels of plasma glucose was（21.44±10.97）mmol/L.（2）The causes of DKA gestation：diabetes mellitus diagnoses were not made before pregnancy in four patiens（57.14%）.The plasma glucose were not controlled well and the DKA happened after occurring gestational hypertension and using cortical hormone（28.57%）.One was because of stopping using insulin after cesarean section（14.19%）.（3）Outcomes of pregnancy：no maternal mortality occurred and only one baby died（14.29%）.Conclusion：DKA usually occurres in the pregnancy patients complicated with diabetes mellitus whose plasma glucose is badly controlled.

关 键 词：妊娠期 糖尿病 酮症酸中毒 诱因 

分 类 号：R714.25[医药卫生—妇产科学]