糖尿病酮症酸中毒并社区获得性肺炎临床分析  

Clinical Analysis on 12 Cases of Diabetic Ketoacidosis with Community-Acquired Pneumonia

作　　者：苗丽[1] 薛艳明[2] 李雪莉[1] 蔡娜[1] 尚愚[1] 赵庆东[1] 

机构地区：[1]哈尔滨市第一医院呼吸内科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第二医院血液科,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2015年第26期5094-5097,共4页Progress in Modern Biomedicine

基　　金：黑龙江生教育厅科学技术研究项目(12511339);黑龙江省自然科学基金项目(D 2007 97)

摘　　要：目的：探讨糖尿病酮症酸中毒合并社区获得性肺炎的临床特点、治疗方法,为临床预防和治疗提供方法。方法：对2013年1月~2014年11月入住我院呼吸科病房的12例糖尿病酮症酸中毒合并社区获得性肺炎患者的临床资料、治疗、转归进行回顾性分析。结果：糖尿病酮症酸中毒合并社区获得性肺炎的患者危险因素有：意识状态、肺部基础疾病、贫血、低蛋白血症、血糖水平及降糖药物使用情况、年龄。经充分补液、小剂量胰岛素消酮、控制血糖、抗感染、呼吸机辅助通气、纠正离子紊乱及加强对症支持治疗后患者均好转出院。结论：在糖尿病酮症酸中毒合并社区获得性肺炎患者的诊治过程中,控制血糖是治疗的基础,抗感染是治疗的关键,同时改善营养和其他器官的功能状态可明显提高治愈率和降低病死率。Objective： To explore the clinical manifestations and measures for Diabetic Ketoacidosis （DKA） in patients with Community-Acquired Pneumonia （CAP） and provide support for precaution. Methods： The climcal features, treatments and disease outcomes of 12 patients suffering from Diabetic Ketoacidosis with CAP diagnosed in our respiratory ward from January 2013 to November 2014 were retrospectively analyzed. Results： The probable risk factors of diabetic ketoaeidosis with CAP were conscious state, pulmonary underlying disease, anemia, hypoproteinemia, blood glucose level, the state of using glucose-lowing drugs and age. The total patients were cured by fluid infusion, using low-dose insulin to eliminating Ketosis, controlling blood glucose, anti-infection, non-invasive positive-pressure vent＇flation and improved nutritional state. Conclusions： In clinical treatment of diabetic Ketoacidosis patients with CAP, controlled blood glucose was the basis of treatment, anti-infection was the key, improved the status of nutrition and organ function can improve cure rate and significantly decrease mortality.

关 键 词：糖尿病酮症酸中毒 社区获得性肺炎 危险因素 治疗 

分 类 号：R587.2[医药卫生—内分泌] R563[医药卫生—内科学]