临床误诊误治2024，Vol.37Issue(14)：10-13,4.DOI:10.3969/j.issn.1002-3429.2024.14.003
糖尿病酮症酸中毒临床误诊分析
Analysis of Clinical Misdiagnosis of Diabetic Ketoacidosis
摘要
Abstract
Objective To analyze the causes of misdiagnosis of diabetic ketoacidosis(DKA),so as to improve the vigilance and diagnostic accuracy of clinicians.Methods The clinical data of 3 DKA patients initially diagnosed with other diseases from 2020 to 2023 were retrospectively analyzed.Results One patient initially presented with severe upper abdomi-nal pain,nausea and vomiting,and was considered to have acute pancreatitis by laboratory examination.The main symptoms of 1 patient were abdominal distension,abdominal pain and constipation,with initial diagnosis of intestinal obstruction.One patient presented with sudden headache and disturbance of consciousness and was initially diagnosed with acute cerebrovascu-lar accident.After relevant treatment,the condition of the 3 patients did not improve significantly.Further examinations,in-cluding blood glucose,urinary ketone body and arterial blood gas analysis,showed significant increase in blood glucose,strong positive urinary ketone body,and arterial blood gas analysis showed metabolic acidosis;all were diagnosed with DKA.The duration of misdiagnosis was 1-4 d.After diagnosis,all the 3 patients received insulin and rehydration therapy,and their conditions were significantly improved with a good prognosis.Conclusion The clinical manifestations of DKA are diverse and lack specificity,which is more likely to be confused with other emergencies.Early blood glucose,urinary ketone body and ar-terial blood gas analysis should be performed as early as possible in order to timely identify and diagnose DKA and avoid ad-verse consequences caused by misdiagnosis.关键词
糖尿病/酮症酸中毒/误诊/胰腺炎/肠梗阻/脑血管意外/血糖/尿酮体/动脉血气分析Key words
Diabetes mellitus/Ketoacidosis/Misdiagnosis/Pancreatitis/Intestinal obstruction/Cerebrovascular ac-cident/Blood Sugar/Urinary ketone bodies/Arterial blood gas analysis分类
临床医学引用本文复制引用
陶雅辉,房胜辉,李文会..糖尿病酮症酸中毒临床误诊分析[J].临床误诊误治,2024,37(14):10-13,4.基金项目
河北省2016年度医学科学研究重点课题计划项目(20160904) （20160904）
