2型糖尿病（糖尿病肾病）尿路感染尿毒症患者合并皮下血肿及获得.docVIP

2型糖尿病（糖尿病肾病）尿路感染尿毒症患者合并皮下血肿及获得 　 作者：杨博宇 赵文光 宋惠彬 杨立明 【摘要】 总结2型糖尿病（糖尿病肾病）尿路感染尿毒症患者合并皮下血肿与获得性凝血因子缺乏症的诊断与治疗经验。一名56岁女性患者，主诉烦渴多尿血糖升高22年，水肿4年，伴恶心、呕吐1周就诊入院。住院治疗中出现皮下血肿。实验室检查结果：凝血因子（II，VII，IX，X）缺乏。对于2型糖尿病（糖尿病肾病）尿路感染尿毒症患者出现皮下血肿，鉴别诊断有重要的临床意义。获得性凝血因子缺乏（II，VII，IX，X）在2型糖尿病（糖尿病肾病）尿路感染、尿毒症、血液透析后，是皮下血肿的罕见原因。2型糖尿病（糖尿病肾病）尿路感染尿毒症患者合并皮下血肿和获得性凝血因子缺乏症需综合治疗（手术、血液透析、药物），能取得满意的疗效。 【关键词】 2型糖尿病糖尿病肾病； 尿路感染； 尿毒症； 皮下血肿； 获得性凝血因子缺乏症； 诊断与治疗 　　Abstract： The diagnosis and therapy experiences of type Ⅱ diabetes (diabetic nephropathy) urinary tract infection uremic patient with subcutaneous hemorrhage and acquired deficiency of coagulation factors are summarized in the article. A 56-year-old female began to complain of polydipsia hyperuresis hyperglucosemia for 22 years with edema 4 years, with nausea and vomiting 1 week who was brought in renal department. Laboratory evidence indicated that coagulation factors (II, VII, IX, X) were deficiency. There was clinically important significant difference diagnosis for subcutaneous hemorrhage in type Ⅱ diabetes (diabetic nephropathy) patients with urinary tract infection and uremia. Acquired deficiency of coagulation factors (II, VII, IX, X) was a rare cause of subcutaneous hemorrhage in type Ⅱ diabetes (diabetic nephropathy) patient with urinary tract infection and uremia after hemodialysis. These results clearly indicated that type Ⅱ diabetes (diabetic nephropathy) urinary tract infection uremic patient with subcutaneous hemorrhage and acquired deficiency of coagulation factors should be treated with comprehensive management (operation, hemodialysis and drugs) at this moment, which have good therapeutic effects. 　　Key words：Type Ⅱ diabetes (diabetic nephropathy); Urinary tract infection uremia; Subcutaneous hemorrhage; Acquired deficiency of coagulation factors; Diagnosis and therapy 　　糖尿病（diabetes mellitus, DM）是由不同病因和发病机制引起的体内胰岛素绝对或相对不足，导致糖蛋白质和脂肪代谢紊乱，并以高血糖为主要表现的全身性疾病，其中以2型糖尿病（type Ⅱ diabetic）多见。2型糖尿病糖尿病肾病（又称肾小球硬化症glomerulosclerosis）尿路感染尿毒症患者合并皮下血肿和获得性凝血因