Kist-van Holthe J E, van der Heijden A J
Academisch Ziekenhuis, Kinder-en Jeugdcentrum, Leiden.
Ned Tijdschr Geneeskd. 1999 Jan 23;143(4):193-6.
Gastroenteritis is the commonest cause of dehydration in children. Infants and young children dehydrate more easily than adults if fluid intake is insufficient or fluid loss too high because of the combination of a large extracellular volume, a large insensible loss and a mediocre concentrating capacity of the kidney. Fluid loss due to gastroenteritis is often accompanied by electrolyte and acid-base disturbances. Oral rehydration with oral rehydration salts (ORS) is nearly always possible. Re-evaluation after 6 hours is advised especially in young children. Early (< 6-24 hours) resumption of feeding is important. If rehydration with frequent small amounts of ORS at home fails, continuous nasogastric tube feeding in the hospital is a good alternative. In dehydration exceeding 10% of body weight intravenous rehydration is necessary.
肠胃炎是儿童脱水最常见的原因。如果液体摄入量不足或因细胞外液量大、不显性失水量大以及肾脏浓缩能力一般等因素导致液体丢失过多,婴幼儿比成人更容易脱水。肠胃炎导致的液体丢失常伴有电解质和酸碱平衡紊乱。几乎总是可以用口服补液盐(ORS)进行口服补液。建议在6小时后重新评估,尤其是幼儿。尽早(<6 - 24小时)恢复喂养很重要。如果在家中频繁少量使用ORS补液失败,在医院持续鼻饲是一个不错的选择。当脱水超过体重的10%时,需要静脉补液。