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2. 儿童急性感染性腹泻和脱水

2. Acute infectious diarrhoea and dehydration in children.

作者信息

Elliott Elizabeth J, Dalby-Payne Jacqueline R

机构信息

The Children's Hospital at Westmead, NSW.

出版信息

Med J Aust. 2004 Nov 15;181(10):565-70. doi: 10.5694/j.1326-5377.2004.tb06449.x.

Abstract

Gastroenteritis in children is still a common reason for consulting a general practitioner and for hospital admission. Rotavirus is the most common cause of gastroenteritis in children and accounts for half of all hospital admissions for severe acute infectious diarrhoea. Most children with gastroenteritis do not develop dehydration and can be treated at home. Children with mild to moderate dehydration should be treated with low osmolarity oral rehydration solutions, and those with severe dehydration or shock need to be admitted for administration of intravenous fluids. Lactose-free feeds should not be routinely used after acute gastroenteritis, but there is some evidence that a lactose-free diet may reduce the duration of diarrhoea. Antimotility drugs are rarely indicated in children with gastroenteritis, as the potential risks outweigh the benefits. The development of a rotavirus vaccine would provide huge public health benefits and cost savings. Other preventive strategies include educating people about personal and food hygiene and encouraging breastfeeding.

摘要

儿童肠胃炎仍是咨询全科医生及住院治疗的常见原因。轮状病毒是儿童肠胃炎最常见的病因,占所有严重急性感染性腹泻住院病例的一半。大多数肠胃炎患儿不会出现脱水症状,可在家中治疗。轻至中度脱水的患儿应使用低渗口服补液盐治疗,而重度脱水或休克的患儿则需住院接受静脉输液治疗。急性肠胃炎后不应常规使用无乳糖喂养,但有证据表明无乳糖饮食可能会缩短腹泻病程。肠胃炎患儿很少需要使用止泻药,因为潜在风险大于益处。轮状病毒疫苗的研发将带来巨大的公共卫生效益并节省成本。其他预防策略包括对人们进行个人卫生和食品卫生教育以及鼓励母乳喂养。

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