总结5例免疫检查点抑制剂致暴发性1型糖尿病酮症酸中毒患者的护理体会。针对该病起病急、病情危重的特点,采取补液、纠正水电解质及酸碱平衡,规范胰岛素治疗及胰岛素泵的使用,应用免疫检查点抑制剂期间强化血糖监测,出院后的延续性护理及酮症酸中毒的早期识别。经过精心的治疗和护理,5例患者血糖控制稳定,均康复出院,定期随访,无相关并发症发生。
This paper summarized the nursing experience of 5 patients with fulminant type 1 diabetic ketoacidosis caused by immune checkpoint inhibitors. In view of the characteristics of acute onset and critical condition of fulminant type 1 diabetic ketoacidosis caused by immune checkpoint inhibitors,we adopted fluid rehydration,correction of water,electrolyte and acid-base balance,standardized insulin therapy and use of insulin pump,blood glucose monitoring during hospitalization and application of immune checkpoint inhibitors,continuous care after discharge and early identification of ketoacidosis. After careful treatment and other nursing measures,5 patients had stable blood glucose control,were recovered and discharged. Regular follow-up showed no recurrence of related complications.
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