Pizarro D, Posada G, Sandi L, Moran J R
Department of Emergency Medicine, Hospital Nacional de Niños, San José, Costa Rica.
N Engl J Med. 1991 Feb 21;324(8):517-21. doi: 10.1056/NEJM199102213240802.
In infants the treatment of acute diarrhea with glucose-based solutions results in rehydration but does not reduce the severity of diarrhea. Oral rehydration with solutions based on rice powder may reduce stool output as well as restore fluid volume.
We designed a prospective, randomized, double-blind study to evaluate the efficacy of two rice-based rehydration solutions and a conventional glucose-based solution. Solution A contained only rice-syrup solids, solution B contained rice-syrup solids and casein hydrolysate, and solution C, the glucose-based solution, served as control. The study subjects were 86 mildly to moderately dehydrated infant boys, 3 to 18 months old, who were admitted to a children's hospital with acute diarrhea. We measured fluid intake, fecal and urine output, and absorption and retention of fluid, sodium, and potassium at intervals for 48 hours in all 86 infants.
The mean (+/- SE) fecal output was significantly lower in the infants given solution A (group A infants) than in the infants given solution C (group C) (29 +/- 4 vs. 46 +/- 7 ml per kilogram of body weight, P less than 0.05) during the first six hours of therapy. The infants in group A also had greater fluid absorption (221 +/- 16 vs. 167 +/- 9 ml per kilogram, P less than 0.05) over the entire 48 hours of therapy and greater potassium absorption (1.6 +/- 0.2 vs. 0.6 +/- 0.1 mmol per kilogram, P less than 0.05) during the first six hours than the infants in group C. Solution B offered no advantages over solution A.
Solutions containing rice-syrup solids were effective in the rehydration of infants with acute diarrhea. They decreased stool output and promoted greater absorption and retention of fluid and electrolytes than did a glucose-based solution.
在婴儿中,使用含葡萄糖溶液治疗急性腹泻可实现补液,但不能减轻腹泻的严重程度。使用基于米粉的溶液进行口服补液可能会减少粪便排出量并恢复液体量。
我们设计了一项前瞻性、随机、双盲研究,以评估两种基于大米的补液溶液和一种传统的基于葡萄糖的溶液的疗效。溶液A仅含有米糖浆固体,溶液B含有米糖浆固体和酪蛋白水解物,而溶液C(基于葡萄糖的溶液)用作对照。研究对象为86名3至18个月大的轻度至中度脱水男婴,他们因急性腹泻入住一家儿童医院。我们在所有86名婴儿中每隔一段时间测量48小时的液体摄入量、粪便和尿液排出量以及液体、钠和钾的吸收和潴留情况。
在治疗的前六个小时内,给予溶液A的婴儿(A组婴儿)的平均(±标准误)粪便排出量显著低于给予溶液C的婴儿(C组)(每公斤体重29±4 vs. 46±7毫升,P<0.05)。在整个48小时的治疗过程中,A组婴儿的液体吸收量也更大(每公斤221±16 vs. 167±9毫升,P<0.05),并且在治疗的前六个小时内,A组婴儿的钾吸收量比C组婴儿更大(每公斤1.6±0.2 vs. 0.6±0.1毫摩尔,P<0.05)。溶液B与溶液A相比没有优势。
含有米糖浆固体的溶液对急性腹泻婴儿的补液有效。与基于葡萄糖的溶液相比,它们减少了粪便排出量,并促进了更多的液体和电解质吸收及潴留。