Clinical Characteristics Of Children With Diabetic Ketoacidosis Complicated With Acute Pancreatitis

Objective: To study the clinical features,improve clinicians' understanding of the disease and reduce the missed diagnosis and misdiagnosis,the occurrence,development,treatment and prognosis of DKA complicated with AP are explored.At the same time,the impact of related factors on the disease are also systematically investigated for early diagnosis and early treatment,clinical guidance and reducing the incidence of adverse consequences.improving medical staff and the public awareness of DKA complicated by AP.Methods: The clinical data of 18 patients with DKA complicated with AP admitted to Shengjing Hospital of China Medical University from January 2009 to February 2018 were retrospectively analyzed.At the same time,20 patients with DKA without acute pancreatitis were selected as the control group.The patients were divided into two groups according to age,family history,clinical symptoms,white blood cell count,blood glucose,C peptide,insulin,glycosylated hemoglobin,Enzyme,lipase,fasting water time,the time needed to correct acidosis,the time required to return to normal pancreatin,the use of proton pump inhibitors,whether antibiotics are used,whether gastrointestinal decompression and other related factors.Results: The time of symptom onset was 4.5(2.75-10.0)days in the group with AP and 11.50(7.0-30.0)days in the control group,P<0.05.The difference was statistically significant,So,the onset of AP was more abrupt.In the AP group,there were 12 patients(66.7%)of precursor infection history,and 3 cases(15.0%)of control group.The difference was statistically significant(P<0.05).There were 12 patients(66.7%)of abdominal pain in patients with AP,and the control group had In 3 patients(15.0%),P=0.002,the difference was statistically significant.The duration of abdominal pain was 62.00(57.50-97.25)hours in the AP group and 27.00(24.0-39.75)hours in the control group,P<0.05,the difference was statistically significant.Significance: The duration of abdominal pain in the AP group was longer than that in the DKA group.The amylase value of the AP group was 450.0(243.0-612.5)U/L,and the control group was 26.3(21.0-34.0)U/L,P=0.00,the difference was statistically significant(P<0.05).The AP group had a lipase value of 695.5(334.75-1219.25)U/L,and a control group of 17.85(10.47-51.17)U/L.The difference was statistically significant(P<0.05).There were 6 cases(33.3%)with imaging changes in the AP group.The imaging examinations were normal in the control group.The difference was statistically significant(P<0.05).There was a change in pancreatic imaging in pancreatitis.The fasting time of the AP group was 54.00(23.75-120.0)hours,and the control group was 21.00(17.00-25.00)hours.The difference was statistically significant(P<0.05).The AP group had a longer fasting period.The hospitalization time of the pancreatitis group was 15.00(13.00-19.25)days,and that of the control group was 11.0(9.00-12.00)days.The difference was statistically significant(P<0.05).The hospitalization time of the AP group was longer.Conclusions: Compared with DKA,DKA combined with AP has a more rapid onset,most of which have a history of pre-infection,often with severe abdominal pain and a long duration,and are not easy to relieve.The value of amylase and lipase are significantly elevated,and are associated with pancreatic imaging.Treating this disease usually require longer fasting times and significantly longer hospital stays.