摘要
目的探讨重症糖尿病酮症酸中毒患者的临床急诊急救方法与效果。方法选取2018年11月-2020年11月于该院收治的104例重症糖尿病酮症酸中毒患者为研究对象,将其随机均分为对照组和研究组,每组52例。两组均接受补液、补钾与酮症酸中毒纠正等常规治疗,并给予对照组患者以静脉滴注胰岛素治疗,研究组患者以皮下注射胰岛素治疗,比较两组患者治疗前后的血糖与血红蛋白浓度的变化情况、酮症酸中毒纠正与尿酮体转阴时间、临床疗效与低血糖的发生情况。结果经过治疗后观察分析,研究组治疗后的FPG、2 hPG与HbA1c水平分别为(4.09±1.16)mmol/L、(6.11±0.77)mmol/L、(4.43±1.24)%,较治疗前与对照组治疗后均明显更低,差异有统计学意义(P<0.05);研究组患者酮症酸中毒纠正与尿酮体转阴时间分别为(5.33±1.12)h、(11.31±2.14)h,较对照组均明显更短,差异有统计学意义(P<0.05);研究组患者临床治疗总有效率为94.23%,较对照组的76.92%明显更高,差异有统计学意义(χ^(2)=6.310,P<0.05);研究组患者低血糖的发生率为7.69%,较对照组的26.92%明显更低,差异有统计学意义(χ^(2)=6.718,P<0.05)。结论针对重症糖尿病酮症酸中毒患者,及时给予补液、降血液、纠正水电解质与酸碱失衡、预防并发症等临床急诊急救措施有利缓解患者病情,同时皮下注射胰岛素有利减少不良反应的发生。
Objective To investigate the clinical emergency treatment methods and effects of patients with severe diabetic ketoacidosis.Methods A total of 104 patients with severe diabetic ketoacidosis who were admitted to the hospital from November 2018 to November 2020 were selected as the research subjects,and they were randomly divided into control group and study group,each with 52 patients.Both groups received routine treatments such as fluid rehydration,potassium supplementation,and ketoacidosis correction.The control group was given intravenous insulin therapy,and the study group was given subcutaneous insulin therapy.The blood glucose and hemoglobin concentrations of the two groups were compared before and after treatment,as well as the changes in ketoacidosis,the time for urinary ketones to become negative,the clinical efficacy and the occurrence of hypoglycemia.Results After observation and analysis after treatment,the levels of FPG,2 hPG and HbA1c in the study group after treatment were(4.09±1.16)mmol/L,(6.11±0.77)mmol/L,and(4.43±1.24)%,respectively,compared with those before treatment.The control group was significantly lower after treatment,the difference was statistically significant(P<0.05);the time for correction of ketoacidosis and urinary ketone body negative in the study group were(5.33±1.12)h and(11.31±2.14)h,respectively,which were significantly shorter than those in the control group,the difference was statistically significant(P<0.05);the total effective rate of clinical treatment in the study group was 94.23%,which was significantly higher than 76.92%in the control group,the difference was statistically significant(χ^(2)=6.310,P<0.05);the incidence of hypoglycemia in the study group was 7.69%,which was significantly higher than the 26.92%in the control group,the difference was statistically significant(χ^(2)=6.718,P<0.05).Conclusion For patients with severe diabetic ketoacidosis,timely rehydration,blood lowering,correction of water-electrolyte and acid-base imbalance,prevention of complications and other clinical emergency emergency measures are beneficial to alleviate the patient's condition.At the same time,subcutaneous insulin injection is beneficial to reduce the occurrence of adverse reactions.
作者
姚丽丽
胡明森
时详
YAO Lili;HU Mingsen;SHI Xiang(Department of Critical Care Medicine,Rizhao Central Hospital,Rizhao,Shandong Province,276800 China;Emergency Department of Rizhao Central Hospital,Rizhao,Shandong Province,276800 China)
出处
《糖尿病新世界》
2021年第8期26-30,共5页
Diabetes New World Magazine
关键词
糖尿病
酮症酸中毒
急诊急救
补钾
效果分析
Diabetes
Ketoacidosis
Emergency first aid
Potassium supplementation
Effect analysis
