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并发异位妊娠时应激诱发的糖尿病酮症酸中毒:一例报告

Stress-induced diabetic ketoacidosis in concurrent ectopic pregnancy: A case report.

作者信息

Elwood Adam D, Misra Neeti

机构信息

Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers University Robert Wood Johnson Medical School, 125 Paterson St, Suite 2160, New Brunswick, NJ 08901, USA.

Department of Obstetrics and Gynecology, Hackensack Meridian Health Network, Women's Health Center, 466 New Brunswick Ave, Perth Amboy, NJ 08861, USA.

出版信息

Case Rep Womens Health. 2023 Mar 4;37:e00492. doi: 10.1016/j.crwh.2023.e00492. eCollection 2023 Mar.

Abstract

Ectopic pregnancy occurs in 1-2% of all pregnancies. The majority occur in the fallopian tube, requiring intervention in the form of methotrexate or surgery. Ruptured ectopic pregnancies can lead to hemodynamic instability, requiring immediate surgical intervention. In the case reported here, the patient presented in diabetic ketoacidosis with a pregnancy of unknown location. Upon further evaluation she was found to have a ruptured ectopic pregnancy and was taken to the operating room for surgical management. We discuss the rarity of these concurrent disorders, the pathophysiology behind stress-induced diabetic ketoacidosis, the effects of elevated glucose in peri-operative management, and the importance of multi-disciplinary approaches to urgent clinical decision-making.

摘要

异位妊娠在所有妊娠中发生率为1% - 2%。大多数异位妊娠发生在输卵管,需要以甲氨蝶呤或手术的形式进行干预。破裂的异位妊娠可导致血流动力学不稳定,需要立即进行手术干预。在本文报道的病例中,患者以糖尿病酮症酸中毒就诊,妊娠部位不明。进一步评估后发现她有破裂的异位妊娠,并被送往手术室进行手术治疗。我们讨论了这些并发疾病的罕见性、应激性糖尿病酮症酸中毒背后的病理生理学、围手术期管理中血糖升高的影响以及多学科方法在紧急临床决策中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0831/10020113/0a35d19bb9de/gr1.jpg

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