国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (5): 549-551.doi: 10.12280/gjfckx.20240441

• 产科生理及产科疾病: 病例报告 • 上一篇    下一篇

妊娠期糖尿病并发血糖正常型酮症酸中毒一例

陈春兰, 刘海蔚()   

  1. 570311 海口,海南医科大学附属海南医院(陈春兰);海南省人民医院/海南医科大学附属海南医院内分泌科(刘海蔚)
  • 收稿日期:2024-05-14 出版日期:2024-10-15 发布日期:2024-10-17
  • 通讯作者: 刘海蔚,E-mail:hndxlhw@126.com
  • 基金资助:
    海南省临床医学中心建设资助项目(琼卫医函[2021]276号);海南省自然科学基金高层次人才课题(821RC685)

A Case of Euglycemic Diabetic Ketoacidosis Complicating Gestational Diabetes Mellitus

CHEN Chun-lan, LIU Hai-wei()   

  1. Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China (CHEN Chun-lan); Department of Endocrinology, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China (LIU Hai-wei)
  • Received:2024-05-14 Published:2024-10-15 Online:2024-10-17
  • Contact: LIU Hai-wei, E-mail: hndxlhw@126.com

摘要:

妊娠期血糖正常型酮症酸中毒(euglycemic diabetic ketoacidosis,eDKA)是妊娠期罕见的致命性急症,可危及胎儿的生命。本文报道1例妊娠期糖尿病孕妇在孕32+3周时发生eDKA,经过积极地静脉补液、胰岛素治疗后,酮症酸中毒得以纠正,最终采用赖脯胰岛素+地特胰岛素控制血糖,避免了紧急剖宫产,孕35+4周时因产科彩色超声提示巨大儿行剖宫产娩出1活女婴,出生体质量4 400 g。

关键词: 糖尿病, 妊娠, 糖尿病酮症酸中毒, 诊断, 治疗, 病例报告

Abstract:

Euglycemic diabetic ketoacidosis (eDKA) during pregnancy is a rare and potentially fatal emergency that can endanger the life of the fetus. This paper reports a case of a pregnant woman with gestational diabetes mellitus who developed eDKA at 32+3 weeks of gestation. After active intravenous fluid replacement and insulin therapy, the ketoacidosis was corrected. Blood glucose was subsequently controlled using a combination of insulin lispro and insulin detemir, avoiding the need for an emergency cesarean section. At 35+4 weeks of gestation, due to obstetric ultrasound indicating macrosomia, a cesarean section was performed, and a live female infant was delivered, weighing 4 400 g.

Key words: Diabetes, gestational, Diabetic ketoacidosis, Diagnosis, Therapy, Case reports