儿童非酮高渗综合征14例报告  

Management of nonketotic hyperosmolar syndrome in children:a report of 14 cases

作　　者：姜武林 

机构地区：[1]浙江省湖州市第一医院,浙江湖州313000

出　　处：《河北医学》2000年第12期1092-1094,共3页Hebei Medicine

摘　　要：目的 :探讨儿童非酮高渗综合征的治疗。方法 :回顾分析 1993年 1月至 1999年 11月收治的 14例儿童非酮高渗综合征的病历。无糖尿病病史 ,13例有诱因 ,14均有脱水和神经精神症状。入院时血糖≥ 2 7.7mmol/ L,血钠≥ 150 mmol/ L,血浆渗透压≥ 350 mosm/ L,仅 2例尿酮体阳性。入院后即快速静脉内输液 ,经胃管灌注温开水 ,同时用小剂量胰岛素控制血糖 ,治疗诱因。结果 :全部病儿在 2～ 3d,神经精神症状好转。治疗第一天血钠 151.38± 1.2 1mmol/ L,血糖 9.75± 1.50 mmol/ L,血浆渗透压 338.4 2± 1.62 mosm/ L。d3血钠 142 .16± 2 .38mmol/ L,血糖 7.2 5± 0 .19mmol/ L,血浆渗透压30 8.62± 4 .2 3mosm/ L。 14例均治愈。结论 :儿童非酮高渗综合征必须迅速补充血容量 ;Objective:To assess the therapy of pediatric nonketotic hyperosmolar syndrome.Methods:The charts of 14 children with nonketotic hyperosmolar syndrome were reviewed between January 1993 and November 1999.All cases had dehydration and neuropsychologic symptoms.At time of admission,the blood sugar values was≥27.7mmol/L,Serum Na +≥150mmol/L,Serum osmolarity≥350mosm/L,ketonuria in 2 cases.14 cases were treated conservatively intravenous fluids,6 of them was plused cool boiled water through gastric tube.Lower dosage of insulin was intravenous infused.[WT5HZ]Results:[WT5BZ]in 2 to 3 days after,Neuropsychologic symptoms of all cases had disappeared.The first day,the blood sugar values was 9.75±1.50mmol/L,Serum Na + 151.38±1.21mmol/L,Serum osmolarity≤338.42±1.62mOsm/L.The third day,the blood sugar Values was≤7.25± 0.19mmol/L,Serum Na +≤142.16±2.38mmol/L,Serum osmolarity≤308.02±4.23mosm/L.[WT5HZ]Conclusions:[WT5BZ]The authors conclude that The initial fluids should be given intraveniosly,a rapid intravenous “push'” 20ml/kg·h of isotonic saline (0.9% Nacl);meanwhile ,the insulin should be given with an infusion pump at a rate calculated to provide 0.05 u/kg·h

关 键 词：糖尿病 非酮高渗综合征 胰岛素 儿童 

分 类 号：R725.8[医药卫生—儿科]