1型糖尿病患儿首次出现糖尿病酮症酸中毒时的成功药物治疗：一例报告
Successful medical management of diabetic ketoacidosis at first presentation in a child with type 1 diabetes: A case report.
作者信息
Sharma Shriya, Adhikari Aakriti, Adhikari Samikshya, Poudel Sabin, Bk Reshu, Mainali Gaurab, Yadav Sumit Kumar
机构信息
Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Shree Birendra Hospital, Kathmandu, Nepal.
出版信息
Ann Med Surg (Lond). 2022 Jun 13;79:103981. doi: 10.1016/j.amsu.2022.103981. eCollection 2022 Jul.
INTRODUCTION AND IMPORTANCE
Diabetic ketoacidosis (DKA) is considered to be a common presentation of type 1 diabetes mellitus in children. It occurs when absolute or relative insulin insufficiency prevents glucose from entering the cells for use as metabolic fuel, causing the liver to quickly break down fat into ketones for use as fuel source. As a result, ketones are overproduced, accumulating in the blood and urine making the blood acidic.
CASE PRESENTATION
A 4 years and 8 months old child presented with the complaint of abdominal pain and vomiting along with polyurea, polydipsia and polyphagia. Routine examination of blood revealed that increased random blood glucose level. Once diagnosed, DKA was managed with fluid and insulin therapy with close monitoring and supervision.
CLINICAL DISCUSSION
DKA can be easily diagnosed. Proper management should be done on time to prevent complications like hypokalemia, hyponatremia leading to cerebral edema and shock.
CONCLUSIONS
Diabetic awareness programs and school educational tutorials are beneficial for community awareness of the signs and symptoms of diabetes.
引言与重要性
糖尿病酮症酸中毒（DKA）被认为是儿童1型糖尿病的常见表现。当绝对或相对胰岛素不足阻止葡萄糖进入细胞用作代谢燃料时，就会发生这种情况，导致肝脏迅速将脂肪分解成酮用作燃料来源。结果，酮过度产生，在血液和尿液中积聚，使血液呈酸性。
病例介绍
一名4岁8个月大的儿童出现腹痛、呕吐以及多尿、多饮和多食的症状。血液常规检查显示随机血糖水平升高。一旦确诊，DKA通过补液和胰岛素治疗并密切监测和监督进行管理。
临床讨论
DKA易于诊断。应及时进行适当管理，以预防低钾血症、低钠血症等并发症，这些并发症可导致脑水肿和休克。
结论
糖尿病认识项目和学校教育教程有助于提高社区对糖尿病体征和症状的认识。
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