糖尿病乳酸性酸中毒23例临床分析  

Clinical Analysis of 23 Cases of Diabetic Lactic Acidosis

作　　者：尹延伟[1] 张中东[1] 胡爱民[1] 

机构地区：[1]空军总医院急诊部,北京100142

出　　处：《河北医学》2012年第12期1736-1740,共5页Hebei Medicine

摘　　要：目的:探讨糖尿病乳酸性酸中毒的诱发因素、临床特点,提高对糖尿病乳酸性酸中毒的诊断及治疗水平。方法:对确诊为糖尿病乳酸性酸中毒的23例患者临床诊治资料进行回顾性总结和分析。结果:本组23例糖尿病乳酸性酸中毒患者平时口服双胍类降糖药控制血糖者有20例(87.0%);有明确感染病史的患者19例(82.6%);肾功能不全患者11例(47.8%);心功能不全患者8例(34.8%)及肝功能异常患者5例(21.7%)。经积极治疗,23例糖尿病乳酸性酸中毒患者抢救成功18例,死亡5例。结论:糖尿病患者在使用双胍类降糖药,并发感染,器官功能异常等其他情况时能够增加其发生乳酸性酸中毒的风险。糖尿病乳酸性酸中毒发病急,病情严重,死亡率高,其临床表现常被原发疾病的症状、体征所掩盖,临床工作中容易误诊与漏诊,应加以重视。Objective： To investigate the inducement and clinical features of diabetic lactic acidosis. To improve the diagnosis and treatment of patients with diabetic lactic acidosis. Method ：The clinical data of 23 cases for diabetic lactic acidosis were analysed retrospectively. Result：In 23 cases,20 cases with biguanides treatment（ 87.0% } ;19 cases with a clear history of infection（ 82.6% } ; 11 cases with chronic renal insuffi- ciency{47.8% ） ;8 cases with heart failure（34.8% ） ; 5 cases with abnormal liver function{21.7% }. After active treatment, 18 cases with successful rescue, and 5 cases with death. Conclusion： Using biguanides treatment, infection and organ dysfunction can increase the risk of diabetic lactic acidosis for diabetic pa- tients. Diabetic lactic acidosis is an acute disease and has such characteristics as seriously condition and high case mortality rate. Clinical manifestations of diabetic lactic acidosis were usually covered by signs and symp- toms of primary diseases, causing missed diagnosis and misdiagnosis frequently. So we should attach importance to this disease.

关 键 词：乳酸性酸中毒 糖尿病 诱发因素 治疗 

分 类 号：R587.2[医药卫生—内分泌]