Odey F A, Etuk I S, Etukudoh M H, Meremikwu M M
Department of Paediatrics, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
Niger Postgrad Med J. 2010 Mar;17(1):19-22.
To describe the acid base and electrolyte pattern of morbidity and mortality in children with diarrhoea and protein energy malnutrition.
The diarrhoea treatment and training unit of the university of Calabar teaching hospital was used for the study.
DESIGN/METHODS: It was a prospective study in which consecutive children below the age of 15 years with protein energy malnutrition and diarrhoeal diseases admitted into the DTU were screened for acid base and serum electrolyte abnormalities. The study was carried out over a two year period from January 1997 to December 1998.
Hypokalaemia was seen in 45 (23.4%) patients. This was second to acidosis. Metabolic acidosis was the commonest abnormality in this study and was seen in 108(56.3%) of the patients included in the study. There was hyponatraemia in 25(13%). Hypochloraemia in 8(4.2%) and hypernatraemia in 6(3.1%) of the patients respectively.
This study has shown that hypokalaemia is a common electrolyte abnormality in children with severe protein energy malnutrition and diarrhoeal diseases. There is need to encourage the use of readily available interventions such as the UNICEF and WHO oral rehydration solution in patients with diarrhoea and/or severe protein energy malnutrition to reduce morbidity and mortality from acid base and electrolyte disturbances.
描述腹泻伴蛋白质能量营养不良患儿发病及死亡时的酸碱和电解质情况。
研究采用了卡拉巴尔大学教学医院的腹泻治疗与培训单元。
设计/方法:这是一项前瞻性研究,对连续收治入腹泻治疗单元的15岁以下患有蛋白质能量营养不良和腹泻疾病的儿童进行酸碱及血清电解质异常筛查。研究于1997年1月至1998年12月的两年期间开展。
45例(23.4%)患者出现低钾血症,仅次于酸中毒。代谢性酸中毒是本研究中最常见的异常情况,在纳入研究的患者中有108例(56.3%)出现。25例(13%)患者出现低钠血症。分别有8例(4.2%)患者出现低氯血症,6例(3.1%)患者出现高钠血症。
本研究表明,低钾血症是患有严重蛋白质能量营养不良和腹泻疾病儿童常见的电解质异常情况。有必要鼓励对腹泻和/或严重蛋白质能量营养不良患者使用如联合国儿童基金会和世界卫生组织口服补液盐等现成的干预措施,以降低酸碱和电解质紊乱导致的发病率和死亡率。