Moreno-Sánchez H, Velásquez-Jones L, Becerra F C, Faure A, Maulén I, de León M, Abraham-Jalil A, Muraira A
Hospital Infantil de Monterrey, Nuevo León, México, D.F.
Bol Med Hosp Infant Mex. 1990 Sep;47(9):630-5.
A total of 186 infants, suffering from acute diarrhea were studied and divided into two groups: 84 children were placed in group A and given the ORS recommended by the World Health Organization which contains sodium and glucose at concentrations of 60 and 90 mmol/L respectively and an osmolality of 311 mOsm/kg (mmol/kg) (ORS-90). Group B included 82 children who received an ORS containing sodium and glucose at concentrations of 60 and 90 mmol/L respectively and with an osmolality of 240 mOsm/kg (mmol/kg) (ORS-60). Seven belonging to group A (8.3%) required intravenous rehydration due to the severity of the diarrhea (three cases), persistent vomiting (three cases) and paralytic ileus (one case), while only two cases belonging to group B (2.5%) required intravenous rehydration due to severe losses through feces (one case) and another due to paralytic ileus (one case). No differences were observed due to the variations in sodium concentrations among either of the groups of patients, whether that be in the natremias when admitted or once rehydrated, with a general tendency towards the correction of the hypernatremia or hyponatremia seen during admittance with both types of ORS. A similar situation was observed with the variations in serum potassium. The results obtained from this study show the different advantages of using an ORS with lesser sodium and glucose concentrations as well as minor osmolality with those from using the solution recommended by the World Health Organization, when a lesser index of failures is observed in the treatment of children with acute diarrhea with oral rehydration therapy. Yet before widely recommending its' use, it should be demonstrated that the new ORS induces lesser losses through feces during the rehydrating period in children dehydrated due to acute diarrhea.
对186名患有急性腹泻的婴儿进行了研究，并将他们分为两组：84名儿童被归入A组，给予世界卫生组织推荐的口服补液盐（ORS），其钠和葡萄糖浓度分别为60和90 mmol/L，渗透压为311 mOsm/kg（mmol/kg）（ORS - 90）。B组包括82名儿童，他们接受的ORS中钠和葡萄糖浓度分别为60和90 mmol/L，渗透压为240 mOsm/kg（mmol/kg）（ORS - 60）。A组中有7名（8.3%）因腹泻严重（3例）、持续呕吐（3例）和麻痹性肠梗阻（1例）需要静脉补液，而B组中只有2例（2.5%）因严重粪便丢失（1例）和另1例因麻痹性肠梗阻需要静脉补液。两组患者中，无论入院时还是补液后，钠浓度的变化均未观察到差异，两种类型的ORS在入院时均呈现出纠正高钠血症或低钠血症的总体趋势。血清钾的变化情况也类似。本研究结果表明，与使用世界卫生组织推荐的溶液相比，使用钠和葡萄糖浓度较低且渗透压较小的ORS具有不同的优势，在口服补液疗法治疗急性腹泻儿童时观察到较低的失败率。然而，在广泛推荐其使用之前，应证明新的ORS在急性腹泻脱水儿童的补液期间导致的粪便丢失较少。
