Analysis of risk factors and nursing strategies for children with diabetic ketoacidosis complicated with cerebral edema

Objective To count the clinical data of diabetic ketoacidosis(DKA)children and DKA with cerebral edema, analyze the risk factors of DKA with cerebral edema, and summarize the nursing countermeasures. Methods The data of 189 cases of DKA without cerebral edema and 27 cases of DKA with cerebral edema were collected in Ningbo Women and Children Hospital from July 2014 to February 2019. The age, blood glucose, pH value, blood sodium slow rising, persistent hyponatremia, blood urea nitrogen elevating, and bicarbonate concentration were counted, and single factor and logistic regression analysis were used to determine the risk factor of DKA with cerebral edema. Results Univariate analysis showed that the difference between two groups was significant on age, blood glucose, pH value, blood sodium slow rising, persistent hyponatremia, blood urea nitrogen elevating, and bicarbonate concentration. Logistic analysis showed that age≤6 years(OR=3.456, P=0.002), blood glucose>20 mmol/L(OR=3.331, P=0.001), pH≤7.35(OR=3.543, P=0.004), blood sodium slow rising(OR=2.543, P=0.004), persistent hyponatremia(OR=2.112, P=0.019), blood urea nitrogen elevating(OR=2.400, P=0.021), and bicarbonate concentration>10 mmol/L(OR=2.732, P=0.048) were risks factors of DKA with cerebral edema. Conclusion Age≤6 years, blood glucose>20 mmol/L, pH value≤7.35, blood sodium slow rising, persistent hyponatremia, blood urea nitrogen elevating, and bicarbonate concentration>10 mmol/L were risks factors of DKA with cerebral edema. The risk factors should be emphasized in clinical practice, and sexual treatment and nursing should be done to prevent the occurrence of cerebral edema.