成人隐匿性自身免疫性糖尿病误行代谢手术致营养不良剖析

发布时间：2018-04-23 04:29

本文选题：糖尿病 + 自身免疫　；参考：《临床误诊误治》2016年12期

【摘要】：目的探讨成人隐匿性自身免疫性糖尿病(latent autoimmune diabetes in adults,LADA)的临床特征,减少误诊误治。方法对我院收治并误行代谢手术的LADA 1例的临床资料进行回顾性分析。结果本例因多饮、多尿3.5年,胃转流术后恶心、食欲缺乏、消瘦2年余,视物模糊及足趾麻木3个月就诊。病初在未明确病情的情况下予降糖治疗,后行胃转流术逐渐出现恶心、食欲缺乏、消瘦,入我院后完善胰岛细胞抗体(ICA)、馒头餐试验、糖化血红蛋白、血红蛋白及胃镜等检查,诊断为LADA、胃转流术后胃肠功能紊乱、空肠溃疡、小细胞低色素贫血及营养不良,予对症治疗后症状好转出院。4个月后电话随访诉症状好转。结论糖尿病患者行代谢手术治疗逐渐增多,术前明确诊断尤为重要,临床应严格把握手术指征,关注术后营养代谢并发症。
[Abstract]:Objective to investigate the clinical features of adult latent autoimmune diabetes mellitus (autoimmune diabetes in adulthood) and to reduce misdiagnosis and mistreatment. Methods the clinical data of 1 case of LADA treated by metabolic surgery in our hospital were retrospectively analyzed. Results this case was treated for 3 months because of polydrink, polyuria 3.5 years, nausea, lack of appetite, wasting for more than 2 years, blurred vision and numbness of toes after gastric bypass. The patients were treated with hypoglycemia at the beginning of the disease without definite condition. After gastric bypass operation, nausea, lack of appetite, wasting gradually appeared. After entering our hospital, the islet cell antibodies were improved, steamed bread meal test, glycosylated hemoglobin, hemoglobin, gastroscopy, etc. Lada was diagnosed as gastrointestinal dysfunction, jejunal ulcer, small cell hypochromic anemia and malnutrition after gastric bypass. Conclusion Metabolic surgery is increasing in patients with diabetes mellitus. It is very important to make a definite diagnosis before operation. We should strictly grasp the indications of operation and pay attention to the complications of nutritional metabolism after operation.
【作者单位】：安徽医科大学第一附属医院内分泌科;
【分类号】：R587.1;R656

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