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我们能否有效预测1型糖尿病患儿酮症酸中毒病程中脑水肿的发生?——病例报告及文献综述。

Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? - case report and literature review.

作者信息

Jeziorny Krzysztof, Waszczykowska Arleta, Barańska Dobromiła, Szadkowska Agnieszka, Młynarski Wojciech, Zmysłowska Agnieszka

机构信息

Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland.

Department of Ophthalmology and Vision Rehabilitation, Medical University of Lodz, Lodz, Poland.

出版信息

J Pediatr Endocrinol Metab. 2020 Feb 25;33(2):319-322. doi: 10.1515/jpem-2019-0440.

Abstract

Background Cerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient. Case presentation We present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Early diagnosis of CE development in the course of DKA using non-invasive methods such as pachymetry or transorbital ultrasound seems to be a very important prognostic factor. Conclusions This case highlights the importance of appropriate treatment according to the newest recommendations and presents the usefulness of new diagnostic methods to assess the risk of CE in children with newly diagnosed T1D.

摘要

背景 脑水肿(CE)是糖尿病酮症酸中毒(DKA)最严重的并发症之一,可导致中枢神经系统(CNS)紊乱,甚至导致患者死亡。病例报告 我们报告一例11岁新诊断为1型糖尿病(T1D)的男孩发生严重DKA的病例。DKA诊断延迟及一些治疗问题导致了CE的发生和直接危及生命的状况。使用诸如测厚法或经眶超声等非侵入性方法早期诊断DKA过程中的CE发展似乎是一个非常重要的预后因素。结论 本病例突出了根据最新建议进行恰当治疗的重要性,并展示了新诊断方法在评估新诊断T1D儿童CE风险方面的实用性。

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