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本文总结1980～1981年期间采用小剂量胰岛素治疗44例糖尿病酮症酸中毒的经验。本组全部采用小剂量胰岛素2.4～12u/h加入生理盐水中持续静滴、直至血糖下降至250mg/dl。该法疗效良好、治愈43例(97.73%)、血糖降至250mg/dl平均需6.19±5.29h、胰岛素平均用量为31.9±23.7u,血糖每小时平均下降66.45mg/dl。本文着重讨论以下四点:1.本疗法对多数用过胰岛素治疗和胰岛素抗体存在者仍有效。2.分析了重症病人酮症纠正延迟的原因,并提出处理方法。3.指出糖尿病酮症酸中毒高渗性昏迷的处理方法。4 游离脂肪酸测定可作为糖尿病酮症酸中毒的诊断指标,有助于同非酮症高渗性昏迷的鉴别。
This article summarizes the experience of using small doses of insulin to treat 44 cases of diabetic ketoacidosis during 1980-1981. This group all use small doses of insulin 2.4 ~ 12u / h added intravenous infusion of normal saline until the blood glucose dropped to 250mg / dl. The method was effective and cured in 43 cases (97.73%), blood glucose dropped to 250mg / dl an average of 6.19 ± 5.29h, the average amount of insulin was 31.9 ± 23.7u, the average hourly blood glucose dropped 66.45mg / dl. This article focuses on the following four points: 1. The therapy is still effective for most insulin-treated and insulin-resistant patients. Analysis of the reasons for the delay in the correction of ketosis in critically ill patients, and propose ways to deal with it. 3. Pointed out diabetic ketoacidosis hyperosmolar coma treatment. 4 Determination of free fatty acids can be used as a diagnostic indicator of diabetic ketoacidosis, contribute to the identification of non-ketotic hyperosmolar coma.