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成人糖尿病酮症酸中毒中的致命性脑水肿

Fatal cerebral oedema in adult diabetic ketoacidosis.

作者信息

Haringhuizen A, Tjan D H T, Grool A, van Vugt R, van Zante A R H

机构信息

Department of Intensive Care, Gelderse Vallei Hospital, Ede, the Netherlands.

出版信息

Neth J Med. 2010 Jan;68(1):35-7.

Abstract

In this report, a case of adult onset fatal cerebral oedema as a rare complication of diabetic ketoacidosis (DKA) is described and confirmed at post-mortem pathological examination. The pathogenesis of cerebral oedema due to DKA is still unknown. Potential mechanisms include the administration of sodium bicarbonate leading to intracellular acidosis, excessive fluid infusion causing swelling of brain tissue, or reduction of plasma osmolarity by a rapid fall in glucose levels causing osmotic swelling.

摘要

在本报告中,描述了一例成人起病的致命性脑水肿,这是糖尿病酮症酸中毒(DKA)的一种罕见并发症,并在尸检病理检查中得到证实。DKA所致脑水肿的发病机制尚不清楚。潜在机制包括给予碳酸氢钠导致细胞内酸中毒、过多液体输注导致脑组织肿胀,或血糖水平快速下降导致血浆渗透压降低引起渗透性肿胀。

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