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重度小儿高血糖高渗综合征的积极液体复苏:一例报告

Aggressive fluid resuscitation in severe pediatric hyperglycemic hyperosmolar syndrome: a case report.

作者信息

Murthy Srinivas, Sharara-Chami Rana

机构信息

Department of Pediatrics, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.

出版信息

Int J Pediatr Endocrinol. 2010;2010:379063. doi: 10.1155/2010/379063. Epub 2010 Mar 18.

Abstract

Objective. This report describes a severe case of hyperglycemic hyperosmolar syndrome complicated by rhabdomyolysis, acute kidney injury, hyperthermia, and hypovolemic shock, with management centred upon fluid administration. Design. Case report. Setting. Pediatric intensive care unit in university teaching hospital. Patients. 12 years old adolescent female presenting with hyperglycemic hyperosmolar syndrome with a new diagnosis of type 2 diabetes mellitus. Intervention. Aggressive fluid resuscitation and insulin. Main results. The patient had a good outcome, discharged home on hospital day 6. Conclusions. Hyperglycemic hyperosmolar syndrome is associated with a number of complications. Management strategies are undefined, given the rarity of its presentation, and further studies are warranted.

摘要

目的。本报告描述了一例严重的高血糖高渗综合征,并发横纹肌溶解、急性肾损伤、高热和低血容量性休克,治疗以液体输注为核心。设计。病例报告。地点。大学教学医院的儿科重症监护病房。患者。一名12岁青春期女性,表现为高血糖高渗综合征,新诊断为2型糖尿病。干预措施。积极的液体复苏和胰岛素治疗。主要结果。患者预后良好,于住院第6天出院。结论。高血糖高渗综合征与多种并发症相关。鉴于其临床表现罕见,管理策略尚不明确,有必要进行进一步研究。

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