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糖尿病酮症酸中毒与昏迷。胰岛素灌注(作者译)

[Diabetic ketoacidosis and coma. Insulin perfusion (author's transl)].

作者信息

Calvo Macías C, Martínez Carrasco M C, Ruza Tarrió F, Alvarado Ortega F

出版信息

An Esp Pediatr. 1980 Apr;13(4):295-306.

PMID:6772060
Abstract

Ten cases of diabetic ketoacidosis treated by low-dose insulin continuous perfusion are reported. The severe period therapeutic guide is exposed in two stages showing the form of correction of the most important ketoacidosis. Insulin doses have been, initially, 0.1 U./Kg. in a bolus, followed by 0.1-0.01 U./Kg./h. till acidosis and dehydration are corrected. Evolution of every case was good, without any important complication. Advantages of this therapeutic modality are appointed: an easy treatment management, lesser glycaemia oscillations and lesser complications than using the conventional method of intermittent high doses. In order to overcome, the acidosis and hyperglicaemia resistance found in some of the severest cases, authors suggest to increase the dose of perfused insulin as well as hydration, Finally, the importance of control and patient care is stressed, recommending their admission to a Paediatric Intensive Care unit.

摘要

报告了10例采用小剂量胰岛素持续灌注治疗的糖尿病酮症酸中毒病例。严重阶段的治疗指南分为两个阶段,呈现出纠正最重要的酮症酸中毒的形式。胰岛素剂量最初为0.1 U./Kg.静脉推注,随后为0.1 - 0.01 U./Kg./h.,直至酸中毒和脱水得到纠正。每例患者的病情进展良好,无任何严重并发症。指出了这种治疗方式的优点:治疗管理简便,血糖波动较小,并发症比使用传统间歇性大剂量方法少。为了克服一些最严重病例中出现的酸中毒和高血糖抵抗,作者建议增加灌注胰岛素的剂量以及补液量。最后,强调了控制和患者护理的重要性,建议将患者收治入儿科重症监护病房。

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