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儿童肠胃炎

Gastroenteritis in children.

作者信息

Dalby-Payne Jacqueline R, Elliott Elizabeth J

机构信息

The Children's Hospital at Westmead, Sydney, Australia.

出版信息

BMJ Clin Evid. 2009 Sep 23;2009:0314.

Abstract

INTRODUCTION

Acute gastroenteritis results from infection of the gastrointestinal tract, most commonly with a virus. It is characterised by rapid onset of diarrhoea with or without vomiting, nausea, fever, and abdominal pain. Diarrhoea is defined as the frequent passage of unformed, liquid stools. Regardless of the cause, the mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration.

METHODS AND OUTCOMES

We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent acute gastroenteritis in children? What are the effects of treatments for acute gastroenteritis in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS

We found 20 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS

In this systematic review, we present information relating to the effectiveness and safety of: rotavirus vaccines for the prevention of gastroenteritis; enteral rehydration solutions (oral or gastric), lactose-free feeds, and loperamide for the treatment of gastroenteritis; and ondansetron for the treatment of vomiting.

摘要

引言

急性胃肠炎是由胃肠道感染引起的,最常见的病因是病毒感染。其特点是腹泻迅速发作,可伴有或不伴有呕吐、恶心、发热和腹痛。腹泻定义为频繁排出不成形的液体粪便。无论病因如何,急性胃肠炎治疗的主要方法是提供足够的液体以预防和治疗脱水。

方法与结果

我们进行了一项系统评价,旨在回答以下临床问题:预防儿童急性胃肠炎的干预措施有哪些效果?治疗儿童急性胃肠炎的方法有哪些效果?我们检索了:截至2007年8月的医学文献数据库(Medline)、荷兰医学文摘数据库(Embase)、考克兰图书馆以及其他重要数据库(《临床证据》定期更新;请查看我们的网站获取本评价的最新版本)。我们纳入了来自美国食品药品监督管理局(FDA)和英国药品和医疗产品监管局(MHRA)等相关组织的危害警示。

结果

我们发现20项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。

结论

在本系统评价中,我们提供了以下方面有效性和安全性的信息:轮状病毒疫苗预防胃肠炎;肠内补液溶液(口服或经胃)、无乳糖喂养和洛哌丁胺治疗胃肠炎;以及昂丹司琼治疗呕吐。

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