临床误诊误治Issue(7)：28-30,3.DOI:10.3969/j.issn.1002-3429.2015.07.009
重度乳酸性酸中毒并心脏骤停一例诊治分析
Characteristics of Severe Lactic Acidosis Complicated with Cardiac Arrest and the Related Literature Review
摘要
Abstract
Objective To investigate the clinical features and the treatment of severe lactic acidosis (LA) and to im-prove the success rate. Methods We carried out a retrospective analysis of clinical data of a patient suffering from cardiac ar-rest with severe LA and a review of the related literature review was made. Results The patient suffered from diarrhea for 3 d, severe abdominal pain for 1 h and was admitted into our hospital for acute myocardial infarction. The patient had a history of diabetes and diabetic nephropathy and took a long-term oral metformin without testing blood sugar regularly. Relevant exam-inations ruled out acute myocardial infarction and aortic dissection, and then, and the blood lactate dehydrogenase was 277. 0 U/ L, and lactic acid was 17 mmol/ L and blood gas analysis revealed metabolic acidosis. Above all, the patient was di-agnosed with diabetes and severe LA. The patient suffered sudden cardiac arrest one hour after admission, then the condition was alleviated gradually after active recovery treatment, and in the end the patient was clinically cured and was discharged 1 month later. Conclusion The patient with severe LA may suffer severe chest and abdominal pain as the main manifestations, even sudden cardiac arrest. On the one hand, timely diagnosis and correct evaluation are important for prognosis. On the other hand, positive early fluid resuscitation, effective respiratory support and hemodialysis treatment are also the key to successful treatment.关键词
酸中毒,乳酸性/心脏停搏/糖尿病/误诊/心肌梗死Key words
Acidosis, lactic/Heart arrest/Diabetes mellitus/Diagnostic error/Myocardial infarction分类
医药卫生引用本文复制引用
刘红升,苏琴,曹阳,姚咏明,赵晓东..重度乳酸性酸中毒并心脏骤停一例诊治分析[J].临床误诊误治,2015,(7):28-30,3.基金项目
全军“十二五”计划重大项目(AWS11J008、BWS12J050) （AWS11J008、BWS12J050）
