Department of Pediatrics, University of Naples Federico II, Naples, Italy.
Curr Opin Gastroenterol. 2013 Jan;29(1):23-30. doi: 10.1097/MOG.0b013e32835a352f.
Acute gastroenteritis (AGE) is a major cause of ED visits, hospitalizations, and prescription of investigations, drugs, and changes in diet. Several guidelines on management have been produced.
There is new information on different rehydration protocols, use of antiemetics, and antidiarrheal drugs that could reduce the burden of AGE. The need of intravenous (i.v.) rehydration is the main cause of hospital admission yet a standardized rehydration scheme is not available. Rehydration therapy through nasogastric tube is better than i.v. rehydration, in children with moderate-severe dehydration. Ultrarapid rehydration has been proposed by enteric or i.v. route to reduce the time in hospital and costs. However, reduced rehydration times are associated with high readmission rates and side effects. Antiemetics may reduce the need of i.v. rehydration because of vomiting and the number of hospital admissions. However, the main antiemetic, ondansetron, has been loaded with a warning for potentially severe side effects. Selected antidiarrheal drugs could reduce the length of stay, but data on their use in inpatients are still not conclusive.
Inappropriate medical interventions are still common in the hospital setting and have a high impact on costs. A validated management is still needed in inpatients.
急性肠胃炎（AGE）是导致急诊就诊、住院、进行检查、开具药物和改变饮食的主要原因。已经制定了几项管理指南。
关于不同的补液方案、止吐药和止泻药的使用，有新的信息可以减轻 AGE 的负担。静脉（i.v.）补液是住院的主要原因，但目前尚无标准化的补液方案。对于中重度脱水的儿童，经鼻胃管补液比 i.v.补液更好。通过肠内或 i.v.途径进行超快速补液已被提议用于减少住院时间和费用。然而，减少补液时间与高再入院率和副作用有关。止吐药可能会减少因呕吐和住院人数而需要 i.v.补液。然而，主要的止吐药昂丹司琼因可能出现严重副作用而被加了警告标签。一些止泻药可以缩短住院时间，但关于其在住院患者中的使用的数据仍不具有结论性。
在医院环境中，不适当的医疗干预仍然很常见，对成本有很大影响。在住院患者中仍需要经过验证的管理方法。
