Jos J, Oberkampf B, Couprie C, Paclot C, Bougnères P
Unité de Diabétologie, Hôpital des Enfants-Malades, Paris.
Arch Fr Pediatr. 1988 Jan;45(1):15-9.
In two groups of children with diabetic ketoacidosis, the effects of intramuscular insulin injections associated with intensive rehydration and alkalisation were compared with low-dose continuous intravenous infusion associated with well-controlled fluid and electrolyte therapy. Although correction of ketoacidosis was as effective with both methods, the second appeared to offer several advantages: 1. More progressive normalization of metabolic parameters; 2. Reduced risks of hypoglycemia and hypokaliemia; 3. Easier control of the decrease in plasma glucose levels; 4. Better correction of hyponatremia; 5. More gradual increase in pH values. These results confirmed that low-dose continuous insulin infusion with proper monitoring of fluid and electrolyte replacement was a safe, simple and effective treatment of diabetic ketoacidosis in children.
在两组糖尿病酮症酸中毒患儿中,对肌肉注射胰岛素联合强化补液及碱化治疗的效果与小剂量持续静脉输注胰岛素联合严格控制液体和电解质治疗的效果进行了比较。尽管两种方法纠正酮症酸中毒的效果相同,但第二种方法似乎具有几个优点:1. 代谢参数更逐步地恢复正常;2. 低血糖和低钾血症风险降低;3. 更容易控制血糖水平下降;4. 更好地纠正低钠血症;5. pH值升高更平缓。这些结果证实,小剂量持续胰岛素输注并适当监测液体和电解质补充是治疗儿童糖尿病酮症酸中毒的一种安全、简单且有效的方法。