ДИАБЕТИЧЕСКИЙ КЕТОАЦИДОЗ У ДЕТЕЙ И ПОДРОСТКОВ: ОТ ПАТОФИЗИОЛОГИИ ДО ПРОФИЛАКТИКИ

Заболеваемость сахарным диабетом 1 типа у детей растет по всему миру. Диабетический кетоацидоз – одно из самых распространенных осложнений данного заболевания, с высоким процентом госпитализаций и смертностью. Половина детей с впервые выявленным сахарным диабетом 1 типа имеет клинические проявления этого осложнения. К факторам риска, которые приводят к диабетическому кетоацидозу на фоне сахарного диабета относят социальные и экономические факторы, нарушение режима инсулинотерапии, инфекционные заболевания. Метаболический ацидоз на фоне гипергликемии, глюкозурии и гипогликемии, с образованием большого количества кетоновых тел, лежит в основе патофизиологического механизма данного состояния. Диагностика диабетического кетоацидоза осуществляется на основании четких клинических и диагностических критериев. Терапевтическая тактика при данном осложнении должна основываться на четком лечебном алгоритме, который имеет свои особенности в педиатрической практике и включает: инфузионную терапию, внутривенную инсулинотерапию, профилактику и лечение отека головного мозга, коррекцию гипокалиемии. Профилактические мероприятия при диабетическом кетоацидозе имеют важное терапевтическое значение, которые могут снижать процент возникновения данного осложнения у детей и подростков.

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