急性胃肠炎患儿脱水严重程度的临床与实验室评估
Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis.
作者信息
Parkin Patricia C, Macarthur Colin, Khambalia Amina, Goldman Ran D, Friedman Jeremy N
机构信息
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
出版信息
Clin Pediatr (Phila). 2010 Mar;49(3):235-9. doi: 10.1177/0009922809336670. Epub 2009 Jun 1.
OBJECTIVE
To evaluate clinical and laboratory assessment of dehydration severity in children, 1 to 36 months, with acute gastroenteritis.
STUDY DESIGN
Clinical and laboratory measures and weight change following rehydration were collected for enrolled children.
SETTING
Pediatric emergency department.
RESULTS
Likelihood ratio (LR+) and 95% confidence interval (CI): for a clinical score of 0, the LR+ was 2.2 (95% CI = 0.9-5.3); for a clinical score of 1 to 4, the LR+ was 1.3 (95% CI = 0.90-1.74); for a clinical score of 5 to 8, the LR+ was 5.2 (95% CI = 2.2-12.8); for a venous pH <7.32, the LR+ was 7.2 (95% CI = 2.4-21.9); and for serum bicarbonate <18 mmol/L, the LR+ was 11.6 (95% CI = 3.5-38.0).
CONCLUSION
Clinicians may find it useful to incorporate the Clinical Dehydration Scale and laboratory measures into clinical decision-making algorithms to assess dehydration severity in children with acute gastroenteritis.
目的
评估1至36个月患急性肠胃炎儿童脱水严重程度的临床和实验室评估方法。
研究设计
收集纳入研究儿童的临床和实验室指标以及补液后的体重变化。
研究地点
儿科急诊科。
结果
似然比（LR+）及95%置信区间（CI）：临床评分为0时，LR+为2.2（95%CI = 0.9 - 5.3）；临床评分为1至4时，LR+为1.3（95%CI = 0.90 - 1.74）；临床评分为5至8时，LR+为5.2（95%CI = 2.2 - 12.8）；静脉血pH <7.32时，LR+为7.2（95%CI = 2.4 - 21.9）；血清碳酸氢盐<18 mmol/L时，LR+为11.6（95%CI = 3.5 - 38.0）。
结论
临床医生可能会发现，将临床脱水量表和实验室指标纳入临床决策算法，对于评估急性肠胃炎儿童的脱水严重程度很有用。
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