Page 133 - Phòng Và Điều Trị Bệnh Đái Tháo Đường

Bang 10: Chan doan phan biet
cac dang hon me DTD khac nhau

Hon me toan Hon me tang
ceton dp life tham thau

Dtfdng mau > 300mg/dl > 600mg/dl
(16,7mmol/l) (33,3mmol/l)
S If
Ap ltfc tham < 320 mosm/kg > 320mosm/kg
thau

pH mau < 7,2 binh thtfdng (hay gap)
Kiem dtf <-20 binh thtfdng (hay gap)
Ceton nieu +++ Hiem khi +

- Xet nghiem bo sung:

. Phosphat.

. Lipase, CPK, Ca++, transaminase, TSH cd sd.
. Dien tim, XQ phoi.

. Chan doan phan biet: hon me do cac nguyen
nhan khac.
Dieu tri

o Theo doi tai khoa dieu tri tang ctfdng: dat
monitor, theo doi chat che huyet ap, dat catheter
tinh mach trung tam, do ap ltfc tinh mach trung
tam, lam cac xet nghiem can thiet, co the dat sonde

da day, thd oxy.
v /t O /
o Bu ntfdc: bang dich muoi dang thtfdng; neu Na+ >
155mmol/l: bit dau bang NaCl 4,5%o. Khi dtfdng mau
< 250mg/dl (13,9mmol/l), thay the dich muoi ding

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