摘要
Abstract
Objective To explore the features of children with atypical type Ⅰ diabetic ketoacidosis (DKA),and to improve the diagnostic rate and reduce misdiagnosis.Methods 31 pediatric patients with type Ⅰ DKA who had been treated during the period of 1996 to 2011 in our iospital were divided into typical group (n=19) and atypical group (n=12).Clinical features,laboratory findings,and treatment outcomes were compared between the two groups.Results In the typical group,the diagnosis was confirmed in 17 of the 19 patients who developed symptoms of polydipsia,polyuria,polyphagia,and weight loss at the first visit with a rate of 89.4％ and in 100％ of the patients within three days.For the two patients who were misdiagnosed,one was diagnosed as acute gastroenteritis and the other as septicemia.In the atypical group,3 of the 12 patients occurred coma,4 developed diarrhea,9 had fatigue,weakness,and anorexia,4 had abdominal pain,6 developed irregular deep breathing,12 had dehydration at varying degrees,one had gray complexion with peripheral coldness,and 11 had weight loss all of the 12 patients did not occurred obvious polydipsia,polyuria,and polyphagia,and the diagnosis was confirmed only in two patients at the first visit,with a rate of 16.7％.Conclusions Type Ⅰ DKA of children is easily misdiagnosed.Misdiagnosis causes relate with lack of the knowledge about diabetes,atypical symptoms of child DKA,and no detail of diabetes history.Enhancing the awareness and vigilance of child DKA,combined with the necessary auxiliary examinations,can increase the rate of correct diagnosis and reduce misdiagnosis.关键词
儿童Ⅰ型糖尿病/酮症酸中毒/临床分析Key words
Type Ⅰ diabetes of children/Diabetes ketone acidosis/Clinical analysis
