Hodgkinson Brent, Evans David, Wood Jacky
Department of Public Health, University of Adelaide, Adelaide 5005, South Australia, Australia.
Int J Nurs Pract. 2003 Jun;9(3):S19-28. doi: 10.1046/j.1440-172x.2003.00425.x.
Dehydration is the most common fluid and electrolyte imbalance in older adults. The objectives were to identify the factors that increase the risk of dehydration in older adults, how best to assess the risk and manage oral fluid intake. Data sources included Medline, CINAHL, Cochrane Library, Embase and Current Contents, which were searched until February 2002. Randomized controlled trials for management of adequate fluid intake were undertaken. Cohort and case control studies were used for the identification of risk factors for dehydration. Studies of assessment tools for the identification of dehydration were also considered. Results show that there is no clear determination of the risk factors for dehydration and decreased fluid intake. The recommended daily intake of fluids should be not less than 1600 mL/24 h in order to ensure adequate hydration. A fluid intake sheet and urine specific gravity might be the best methods of monitoring daily fluid intake. Regular presentation of fluids to bedridden older adults can maintain adequate hydration status. In conclusion, more research is required to determine the optimum method of maintaining adequate oral hydration in older adults.
脱水是老年人中最常见的液体和电解质失衡问题。目标是确定增加老年人脱水风险的因素、如何最好地评估风险以及管理口服液体摄入量。数据来源包括医学索引数据库（Medline）、护理学与健康领域数据库（CINAHL）、考科蓝图书馆（Cochrane Library）、荷兰医学文摘数据库（Embase）和现刊目次数据库（Current Contents），检索截至2002年2月。开展了关于管理充足液体摄入量的随机对照试验。队列研究和病例对照研究用于确定脱水的风险因素。还考虑了用于识别脱水的评估工具的研究。结果表明，目前尚无关于脱水风险因素和液体摄入量减少的确切定论。为确保充足的水合作用，建议每日液体摄入量应不少于1600毫升/24小时。液体摄入量记录表和尿比重可能是监测每日液体摄入量的最佳方法。定期向卧床老年人提供液体可以维持充足的水合状态。总之，需要更多研究来确定维持老年人充足口服水合作用的最佳方法。
