摘要
目的探讨糖尿病乳酸酸中毒的临床特点、发病机制及防治措施。方法对1例糖尿病乳酸酸中毒的临床资料进行回顾性分析。结果本例因恶心、呕吐20 h,伴腰背部剧痛10 h急诊入院。有糖尿病史10年,一直未规律服用二甲双胍治疗,血糖控制不理想。此次入院测血压200/90 mmHg,依据其血压及临床表现外院及我院急诊科均拟诊主动脉夹层,予相应治疗效果不佳,病情危重,入我科后经血乳酸、血气分析等检查后确诊为糖尿病乳酸酸中毒,予补液、纠酸、连续性静脉-静脉血液透析滤过(CVVHDF)治疗,痊愈出院。结论临床应提高对糖尿病乳酸酸中毒的防范意识,加强相关知识的普及,及时完善相关检查,避免或减少误诊误治。
Objective To investigate the clinical features, pathogenesis and prevention of lactic acidosis in diabetes. Methods Clinical data of a diabetic patient with lactic acidosis was retrospectively analyzed. Results The patient was e-mergently admitted for vomiting and nausea for 20 h with feeling waist and back pain for 10 h. She had a history of diabetes for 10 years and was irregularly treated with metformin for a long time, and blood sugar was unsatisfactorily controlled. The blood pressure was 200/90 mmHg. On the basis of blood pressure and clinical symptoms, the patient was diagnosed and treated as aortic dissection in Emergency Department of our hospital and outside the hospital, but no significant efficacy. After our de-partment received the patient, the blood lactate and arterial blood gas results made the diagnosis of diabetic lactic acidosis de-fined. After given abundant amount of liquids, sodium bicarbonate and the treatment of continuous venovenous hemodiafiltra-tion （ CVVHDF） , the patient finally recovered. Conclusion It is necessary to raise our awareness of prevention of lactic aci-dosis in diabetes and universal access to the disease＆#39;s knowledge. And we should improve the relevant checks in time to reduce misdiagnosis and mistreatment.
出处
《临床误诊误治》
2014年第9期57-59,共3页
Clinical Misdiagnosis & Mistherapy
关键词
糖尿病
酸中毒
乳酸性
误诊
主动脉
动脉瘤
夹层
Diabetes mellitus
Acidosis,lactic
Diagnostic errors
Aorta
Aneurysm,dissecting
