儿童糖尿病酮症酸中毒合并高甘油三酯性急性胰腺炎2例并文献复习

Two Cases of Diabetic Ketoacidosis Combined with Hypertriglyceridemia Acute Pancreatitis in Children and Literature Review

摘要: 回顾性分析2例儿童DKA合并高甘油三酯性急性胰腺炎(AP)患儿的临床资料并复习相关文献，探讨儿童糖尿病酮症酸中毒(DKA)合并高甘油三酯性AP的发生机制、临床表现、诊断及治疗进展。患儿入院后辅助检查提示DKA合并高甘油三酯性AP诊断明确，给予禁食、静脉补液、调整胰岛素用量、奥曲肽等治疗，并同时积极进行对症治疗。经上述入院治疗后，患儿病情稳定或好转后出院。儿童DKA合并高甘油三酯性AP较成人少见，考虑到胰腺炎通常不典型和非特异性的表现可能会导致误诊和漏诊。因此，在出现恶心、呕吐和腹痛的儿科患者群体中，临床医生要提高认识，做到早发现和早治疗。

Abstract: To retrospectively analyze the clinical data of 2 children with DKA combined with hypertriglyceride acute pancreatitis (AP) and review relevant literature, to explore the mechanisms of childhood di-abetic ketoacidosis (DKA) combined with hypertriglyceride AP. Advances in clinical manifestations, diagnosis, and treatment. After the child was admitted to the hospital, the auxiliary examination showed that the diagnosis of DKA combined with hypertriglyceridemia AP was clear. Treatments such as fasting, intravenous fluid rehydration, adjustment of insulin dosage, and octreotide were given, and symptomatic treatment was actively carried out. After the above hospitalization treat-ment, the child’s condition stabilized or improved and he was discharged. DKA combined with hy-pertriglyceridemia AP is less common in children than in adults, and considering the usually atypi-cal and nonspecific manifestations of pancreatitis, it may lead to misdiagnosis and missed diagnosis. Therefore, among pediatric patients with nausea, vomiting, and abdominal pain, clinicians should increase awareness and achieve early detection and treatment.