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目的提高妊娠糖尿病酮症酸中毒的诊治水平。方法回顾性总结12例妊娠糖尿病酮症酸中毒的孕期相关资料、就诊原因、发病诱因、发病时血糖水平及救治方法和母儿结局。结果妊娠糖尿病伴酮症酸中毒的发生与产检不规范未及时诊断糖尿病、或已诊断糖尿病但未及时用胰岛素有关。就诊原因中半数患者症状典型,半数症状不典型,如:腹痛、心悸胸闷、感染发热。发病诱因与进食不当、自行停用或减少胰岛素用量及感染有关。救治方法是在内分泌医师和产科医师共同配合下迅速控制血糖纠正酮症酸中毒。结论妊娠糖尿病酮症酸中毒多发生于产检不规范,血糖控制不理想孕妇。故规范孕期产检、及时诊断妊娠糖尿病、及时控制血糖、及早应用胰岛素可防止酮症酸中毒的发生。在内分泌医师和产科医师共同配合下可迅速纠正酮症酸中毒,改善母儿结局。
Objective To improve diagnosis and treatment of gestosis diabetic ketoacidosis. Methods 12 pregnant women with gestational diabetic ketoacidosis were retrospectively reviewed. The reasons for the visit, the causes of the disease, the blood glucose level at the time of onset, the treatment and maternal outcomes were analyzed retrospectively. Results The incidence of gestosis with ketoacidosis and childbirth did not promptly diagnose diabetes, or diagnosed with diabetes but not timely insulin-related. Half of the symptoms of patients with typical symptoms, half of the atypical symptoms, such as: abdominal pain, palpitations, chest tightness, fever infection. Incentives and improper eating, self-disable or reduce the amount of insulin and infection. Treatment is in the endocrine physicians and obstetricians in conjunction with the rapid control of blood sugar to correct ketoacidosis. Conclusion Gestational diabetic ketoacidosis occurred in the production of non-standard, poor blood glucose control in pregnant women. Therefore, standardize the pregnancy quarantine, timely diagnosis of gestational diabetes, timely control of blood glucose, insulin as early as possible to prevent the occurrence of ketoacidosis. Under the cooperation of endocrinologists and obstetricians, ketoacidosis can be quickly corrected to improve maternal and child outcomes.