36岁男广州吃生蠔呕吐入ICU 血糖高7倍中毒险丧命 揭8年前忽略1事惹祸
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吃生蠔不只有机会引起肠胃不适,对血糖也有影响?中国内地浙江一名36岁男子吃了生蠔后呕吐不止,送院后更被验出血糖值比正常高7倍,出现中毒情况,几乎送命。后来,医生发现该男子8年来一直忽略一事,导致中毒入院。
吃生蠔后呕吐入ICU 出现严重并发症
中国浙江宁波市医疗中心李惠利医院分享病例指,今年3月初,该名36岁应姓男子与家人到广州旅行,晚上在大排档吃海鲜。喜爱海鲜的他一口气吃了2只烧蠔及1只生蠔。不到1小时,他开始呕吐不止,没有精神,连行路也无力气。
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男子吃生蠔后呕吐,血糖飙高,医生诊断为糖尿病酮症酸中毒。(相片来源:宁波市医疗中心李惠利医院)
到医院看急症后,他肠胃不适的情况仍无改善,因此与家人提前结束旅程,回到宁波慈溪求医。经过详细检查后后现,该男子不只因吃生蠔引发急性肠胃炎,更出现一连串严重并发症,及后被诊断为“糖尿病酮症酸中毒”。
血糖超标7倍 糖尿病酮症酸中毒
该男子入院时血糖高达55mmol/L(正常水平<7.8mmol/L),接受胰岛素治疗、补充液体等治疗后,病情好转。惟翌日,他的肌钙蛋白升高达26.51μg/L(正常范围<0.0342μg/l),医生怀疑是急性心肌梗死或心肌炎所致,认为情况危急,把他送往深切治疗部。
经深切治疗部、心内科及内分泌科医生“三司会诊”,排除了心肌梗死或心肌炎之可能性,最后判断该男子的肌钙蛋白问题是由“酮症酸中毒”引起,治疗重点在于控制血糖,以改善酮症酸中毒。
【同场加映】何谓血糖高?数值有多高代表患糖尿病?
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8年来没控制好血糖 导致酮症酸中毒入院
李惠利医院的张龙医生指出,该男子早于8年前已有糖尿病问题,却一直不按照医瞩注射胰岛素,也没有定期监测血糖变化,因此血糖控制得不理想。是次正是受急性肠胃炎刺激,才导致如此严重的并发症。经过2星期的治疗,该男子康复出院。
张龙医生提醒,糖尿病是一种慢性病,有否做好自我监测,与病情控制效关系密切。糖尿病治疗需要医生和患者合力,病人要定期做好血糖监测,并遵从医嘱用药,更要“管住嘴迈开腿”,控制饮食及多做运动。
什么是“糖尿病酮症酸中毒”?
根据香港卫生署资料,“糖尿病酮症酸中毒”(又名“糖尿病酮酸中毒或糖尿病酮酸血症”)是一种可致命的糖尿病并发症。发病原因及高危因素如下:
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卫生署指,糖尿病酮酸中毒是由于体内胰岛素绝对或相对不足,导致血液内充斥大量糖分及被称为“酮体”的有机酸,多见于一型糖尿病患者。最常见的病发因素是感染,以及忘记注射胰岛素或注射剂量不足。
糖尿病酮症酸中毒10大症状
根据美国梅奥诊所资料,糖尿病酮症酸中毒发病迅速,可能在24小时内就会出现症状,不及时治疗恐有致命风险。常见症状有10种,例如呕吐、虚弱、血糖升高:
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糖尿病酮酸中毒症状:
- 非常口渴
- 尿频
- 作呕并呕吐
- 胃痛
- 虚弱或疲惫
- 气短
- 呼气时有水果味
- 意识混乱
- 更明确的病征包括血糖水平高
- 尿酮水平高
如何及早发现糖尿病?6种症状最常见
据香港医管局资料,糖尿病是一种代谢失调的慢性疾病,患者较常出现下列6种症状:
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