Subclinical brain swelling in children during treatment of diabetic ketoacidosis.
Subclinical brain swelling in children during treatment of diabetic ketoacidosis.
复制标题
糖尿病酮症酸中毒治疗期间儿童亚临床脑肿胀。
DOI：
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发表时间：
1985
影响因子：
158.5
通讯作者：
J. Wolfsdorf
中科院分区：
文献类型：
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作者：
E. Krane;M. Rockoff;J. Wallman;J. Wolfsdorf
临床上明显的脑水肿是糖尿病酮症酸中毒的一种罕见且常常是致命的并发症。为了确定亚临床脑肿胀是否更常见，我们对6名糖尿病酮症酸中毒儿童进行了头颅CT扫描，这些儿童接受了液体复苏和持续小剂量胰岛素治疗。在出院前进行对照扫描。与康复期间的扫描相比，所有六名儿童的早期扫描显示，脑室系统缩小，与脑肿胀相适应。第三脑室和侧脑室的平均直径变化分别为1.3±0.1 mm和3.7±0.8 mm(P<0.01)。此外，在对早期扫描进行盲读时，主观上注意到蛛网膜下腔变窄。虽然没有单一的扫描显示脑水肿，但数据表明，在儿童糖尿病酮症酸中毒的治疗过程中，亚临床脑肿胀可能是常见的。对大脑的连续CT扫描可能提供一种手段来评估旨在预防脑水肿的标准疗法的修改。
Clinically apparent cerebral edema is a rare and often fatal complication of diabetic ketoacidosis. To determine whether subclinical brain swelling occurs more commonly, we obtained cranial CT scans in six children with diabetic ketoacidosis treated with fluid resuscitation and continuous low-dose insulin therapy. Control scans were obtained before hospital discharge. Compared with the scans during convalescence, the early scans of all six children showed a narrowing of the brain's ventricular system, compatible with brain swelling. Average changes in diameter were 1.3 +/- 0.1 mm for the third ventricle and 3.7 +/- 0.8 mm for the lateral ventricles (P less than 0.01). In addition, a narrowing of the subarachnoid spaces was subjectively noted during a blind reading of the early scans. Although no single scan was overtly indicative of cerebral edema, the data suggest that subclinical brain swelling may be a common occurrence during treatment of diabetic ketoacidosis in children. Sequential CT scans of the brain may provide a means of evaluating modifications of standard therapy aimed at preventing cerebral edema.