Ellis E N
University of Arkansas for Medical Sciences, Little Rock.
Pediatr Clin North Am. 1990 Apr;37(2):313-21. doi: 10.1016/s0031-3955(16)36870-5.
Despite many advances in the overall treatment of type I diabetes mellitus during the last few years, no major advance has been made in decreasing the mortality rate of diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic coma. A major concern in both of these disease states is the development of cerebral edema during treatment. The guiding principles of therapy in both disease states are rehydration, electrolyte replacement, insulin therapy, and treatment of any underlying illnesses. If the patient is hypotensive, therapy begins with colloid or normal saline administration to support blood pressure. Fluid and electrolyte deficits should be calculated and replaced during 48 hours. Low-dose insulin therapy is employed for treatment of hyperglycemia. Neurologic function should be carefully monitored and mannitol administered if a change in neurologic function occurs.
尽管在过去几年中I型糖尿病的整体治疗取得了许多进展，但在降低糖尿病酮症酸中毒或高渗高血糖非酮症昏迷的死亡率方面尚未取得重大进展。这两种疾病状态的一个主要问题是治疗期间脑水肿的发生。这两种疾病状态的治疗指导原则是补液、补充电解质、胰岛素治疗以及治疗任何潜在疾病。如果患者血压过低，治疗从给予胶体或生理盐水以维持血压开始。应计算并在48小时内补充液体和电解质缺乏。采用小剂量胰岛素治疗高血糖。应仔细监测神经功能，如果神经功能发生变化则给予甘露醇。
