经胃肠道补液联合静脉补液治疗糖尿病酮症、酮症酸中毒、高渗昏迷临床观察  

Clinical observation of transgastrointestinal fluid infusion in the treatment of diabetic ketosis, ketoacidosis and hy- perosmolar coma

作　　者：马德有 

机构地区：[1]河南省镇平县人民医院急诊科,474250

出　　处：《中国实用医刊》2015年第14期95-97,共3页Chinese Journal of Practical Medicine

摘　　要：目的总结探讨胃肠道补液联合静脉补液在糖尿病患者并发酮症、酮症酸中毒、高渗昏迷治疗中的应用效果。方法选择2011年3月至2012年12月收治的40例糖尿病并发酮症、酮症酸中毒、高渗昏迷患者为研究对象，其中1型糖尿病12例，2型糖尿病28例。所有患者在接受胰岛素治疗的同时经胃肠道充分补液，同时辅助静脉补液。观察患者补液后尿量、血糖、尿酮、进出水量等指标的变化情况。结果40例患者在经过胰岛素及联合补液治疗后，24h尿量均恢复至2000m1以上。尿糖及尿酮浓度逐渐降低，均转为阴性。随着治疗的进行以及病情的好转，患者血糖水平、胰岛素用量、饮水量、静脉输液量以及24h尿量均逐渐下降，且每天测定结果之间比较差异有统计学意义（P〈0．05）。结论在传统静脉补液基础上，联合胃肠道补液能提高糖尿病酮症、酮症酸中毒、高渗昏迷的治疗效果，值得推广使用。Objective To investigate the clinical application of transgastrointestinal fluid infusion in the treatment of diabetic ketosis, ketoacidosis and hyperosmolar coma. Methods Forty patients with diabetes combined by ketosis, ke- toacidosis, hyperosmolar coma from March 2011 to December 2012 were selected. There were 12 cases of type 1 diabetes, 28 cases of type 2 diabetes. All patients were treated with insulin and transgastrointestinal fluid infusion. The changes in u- rine output, blood glucose, ketone, and out of the water and other indicators were analyzed. Results Forty patients after insulin and joint fluid therapy, 24 h urine were restored to 2000 ml or above. Urine glucose and urine ketone concentration decreased, both to negative. As well as improved treatment of the disease, blood glucose levels, insulin dosage, water in- take, intravenous infusion volume and 24 h urine was gradually decreased, and the differences were statistically determined daily （P 〈 0. 05 ）. Conclusions In the traditional intravenous fluids on the basis of joint gastrointestinal fluid can improve the treatment effects of diabetic ketoacidosis, ketoacidosis, hyperosmolar coma.

关 键 词：胃肠道补液联合静脉补液 糖尿病酮症 酮症酸中毒 高渗昏迷 

分 类 号：R743.33[医药卫生—神经病学与精神病学]