糖尿病酮症酸中毒临床误诊分析OACSTPCD

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.