Hoxha Teuta Faik, Azemi Mehmedali, Avdiu Muharrem, Ismaili-Jaha Vlora, Grajqevci Violeta, Petrela Ela
Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
Med Arch. 2014 Oct;68(5):304-7. doi: 10.5455/medarh.2014.68.304-307. Epub 2014 Oct 15.
An accurate assessment of the degree of dehydration in infants and children is important for proper decision-making and treatment. This emphasizes the need for laboratory tests to improve the accuracy of clinical assessment of dehydration. The aim of this study was to assess the relationship between clinical and laboratory parameters in the assessment of dehydration.
We evaluated prospectively 200 children aged 1 month to 5 years who presented with diarrhea, vomiting or both. Dehydration assessment was done following a known clinical scheme.
We enrolled in the study 200 children (57.5% were male). The mean age was 15.62±9.03 months, with more than half those studied being under 24 months old. Overall, 46.5% (93) had mild dehydration, 34% (68) had moderate dehydration, 5.5% (11) had severe dehydration whereas, 14% (28) had no dehydration. Patients historical clinical variables in all dehydration groups did not differ significantly regarding age, sex, fever, frequency of vomiting, duration of diarrhea and vomiting, while there was a trend toward severe dehydration in children with more frequent diarrhea (p=0.004). Serum urea and creatinine cannot discriminate between mild and moderate dehydration but they showed a good specificity for severe dehydration of 99% and 100% respectively. Serum bicarbonates and base excess decreased significantly with a degree of dehydration and can discriminate between all dehydration groups (P<0.001).
Blood gases were useful to diagnose the degree of dehydration status among children presenting with acute gastroenteritis. Serum urea and creatinine were the most specific tests for severe dehydration diagnosis. Historical clinical patterns apart from frequency of diarrhea did not correlate with dehydration status. Further studies are needed to validate our results.
准确评估婴幼儿脱水程度对于正确决策和治疗至关重要。这凸显了进行实验室检查以提高脱水临床评估准确性的必要性。本研究的目的是评估脱水评估中临床参数与实验室参数之间的关系。
我们前瞻性地评估了200名年龄在1个月至5岁之间出现腹泻、呕吐或两者皆有的儿童。按照已知的临床方案进行脱水评估。
我们纳入了200名儿童（57.5%为男性）。平均年龄为15.62±9.03个月，超过半数的研究对象年龄在24个月以下。总体而言，46.5%（93例）有轻度脱水，34%（68例）有中度脱水，5.5%（11例）有重度脱水，而14%（28例）无脱水。所有脱水组患者的历史临床变量在年龄、性别、发热、呕吐频率、腹泻和呕吐持续时间方面无显著差异，而腹泻更频繁的儿童有重度脱水的趋势（p = 0.004）。血清尿素和肌酐无法区分轻度和中度脱水，但它们对重度脱水分别显示出99%和100%的良好特异性。血清碳酸氢盐和碱剩余随脱水程度显著降低，可区分所有脱水组（P<0.001）。
血气分析有助于诊断急性胃肠炎患儿的脱水程度。血清尿素和肌酐是诊断重度脱水最具特异性的检查。除腹泻频率外，历史临床模式与脱水状态无关。需要进一步研究来验证我们的结果。
