糖尿病酮症酸中毒

对于以下情况，考虑 DKA： 

• 已知有糖尿病且身体情况不佳的患者[2]Misra S, Oliver NS. Diabetic ketoacidosis in adults. BMJ. 2015 Oct 28;351:h5660. http://www.ncbi.nlm.nih.gov/pubmed/26510442?tool=bestpractice.com [42]Joint British Diabetes Societies Inpatient Care Group. The management of diabetic ketoacidosis in adults. September 2013 [internet publication]. https://www.diabetes.org.uk/resources-s3/2017-09/Management-of-DKA-241013.pdf [17]Karslioglu French E, Donihi AC, Korytkowski MT. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients. BMJ. 2019 May 29;365:l1114. https://www.doi.org/10.1136/bmj.l1114 http://www.ncbi.nlm.nih.gov/pubmed/31142480?tool=bestpractice.com

  • DKA 最常见于 1 型糖尿病患者，但也可见于 2 型糖尿病患者。[46]Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43. https://www.doi.org/10.2337/dc09-9032 http://www.ncbi.nlm.nih.gov/pubmed/19564476?tool=bestpractice.com [42]Joint British Diabetes Societies Inpatient Care Group. The management of diabetic ketoacidosis in adults. September 2013 [internet publication]. https://www.diabetes.org.uk/resources-s3/2017-09/Management-of-DKA-241013.pdf

• 口渴加重、多尿、近期不明原因体重下降或过度劳累，以及存在以下任意表现的患者：[105]National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. July 2016 [internet publication]. https://www.nice.org.uk/guidance/ng17 [17]Karslioglu French E, Donihi AC, Korytkowski MT. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients. BMJ. 2019 May 29;365:l1114. https://www.doi.org/10.1136/bmj.l1114 http://www.ncbi.nlm.nih.gov/pubmed/31142480?tool=bestpractice.com

  • 恶心和呕吐

  • 腹痛[49]Umpierrez G, Freire AX. Abdominal pain in patients with hyperglycemic crises. J Crit Care. 2002 Mar;17(1):63-7. http://www.ncbi.nlm.nih.gov/pubmed/12040551?tool=bestpractice.com [2]Misra S, Oliver NS. Diabetic ketoacidosis in adults. BMJ. 2015 Oct 28;351:h5660. http://www.ncbi.nlm.nih.gov/pubmed/26510442?tool=bestpractice.com

  • 过度通气（Kussmaul 呼吸）[50]Whited L, Graham DD. Abnormal respirations. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2019. https://www.ncbi.nlm.nih.gov/books/NBK470309/

  • 脱水

  • 意识模糊。

紧急安排静脉血气、血酮和毛细血管血糖检测。