Varavithya W, Sunthornkachit R, Eampokalap B
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Rev Infect Dis. 1991 Mar-Apr;13 Suppl 4:S325-31. doi: 10.1093/clinids/13.supplement_4.s325.
Current guidelines for the management of diarrheal diseases focus on the use of oral rehydration therapy (ORT). Clinically evident dehydration of a moderate degree is not uncommon with invasive diarrhea, and when it occurs, the response to ORT is satisfactory. Studies from hospitals and the community each document the effectiveness of ORT for rehydration of patients with invasive diarrhea. This has been confirmed in a clinical trial of oral rehydration solution (ORS) for the treatment of diarrheal diseases in children less than 5 years of age. Children with moderate dehydration benefited most from ORS, especially those who had culture-proven invasive diarrhea. Significant early weight gain was observed for this group of patients alone after rehydration with ORS. In developing countries, there is no reason to withhold ORT at the first signs of watery or dysenteric diarrhea regardless of the cause and independent of the decision to treat the patient with antimicrobial agents.
腹泻病管理的现行指南侧重于口服补液疗法（ORT）的使用。侵袭性腹泻时临床上明显的中度脱水并不少见，而当出现这种情况时，对ORT的反应是令人满意的。来自医院和社区的研究均证明了ORT对侵袭性腹泻患者补液的有效性。这已在一项口服补液溶液（ORS）治疗5岁以下儿童腹泻病的临床试验中得到证实。中度脱水的儿童从ORS中获益最大，尤其是那些经培养证实为侵袭性腹泻的儿童。仅这组患者在使用ORS补液后就观察到显著的早期体重增加。在发展中国家，无论病因如何，也无论是否决定用抗菌药物治疗患者，在出现水样或痢疾样腹泻的最初迹象时都没有理由不采用ORT。
