Cerebral Edema in Diabetic Ketoacidosis: A Case Report

糖尿病酮酸中毒合併腦水腫：病例報告

徐惠娟(Hui-Chuan Hsu) ； 林秀立(Hsiu-Li Lin) ； 曹心怡(Shin-Yi Tsao)

《重症醫學雜誌》 9卷4期 (2008/12) Pp. 283-287

https://doi.org/10.30035/TCCM.200812.0008

摘要

有症狀腦水腫是糖尿病酮酸中毒病例中少見的併發症，它的致命性相當高，目前還沒有較好的防範方法。
在此我們報告一位17歲女性病患在診斷糖尿病酮酸中毒後十小時出現意識不清，經由電腦斷層確認腦水腫。期間低血鈉一直相隨。在使用類固醇和3% NaCl輸液後，病患恢復正常。藉此案例提醒我們在治療糖尿病酮酸中毒可能遇見的陷阱，同時探討出現腦水腫可能假說、症狀、危險因子與治療方式。

關鍵字

腦水腫 ； 糖尿病酮酸中毒 ； 低血鈉

並列摘要

Symptomatic cerebral edema is a rare complication with high lethality in children diabetic ketoacidosis. There is no consensus on prevention of its development. We report a 17-year-old young lady who presented with conscious deterioration 10 hours after diagnosis of diabetic ketoacidosis. Cerebral edema was confirmed by computerized tomography (CT). Concurrent hyponatremia existed during the period. The mental status recovered after administration of dexamethasone and 3% NaCl. This case may remind physicians of a pitfall in diabetic ketoacidosis. We discuss the hypothesis of etiologies, symptoms, risk factors and management of cerebral edema in DKA patients.

並列關鍵字

Cerebral edema ； Diabetic ketoacidosis ； Hyponatremia