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儿童急性腹泻:使用氢氧化铋凝胶与口服补液盐联合疗法和口服补液盐疗法对腹泻持续时间的测定

Acute Diarrhoea in Children: Determination of Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration Solution Therapy vs. Oral Rehydration Solution.

作者信息

Oviedo Adriana, Díaz Mirna, Valenzuela María Laura, Vidal Victoria, Racca Liliana, Bottai Hebe, Priore Graciela, Peluffo Graciela, Di Bartolomeo Susana, Cabral Graciela, Toca María Del Carmen

机构信息

Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.

Área de Estadística y Procesamiento de Datos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Santa Fe, Argentina.

出版信息

Children (Basel). 2016 Dec 21;3(4):45. doi: 10.3390/children3040045.

Abstract

Oral rehydration salt (ORS) treatment in young children with acute diarrhoea (AD) has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG) and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years). The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group ( = 0.015). The average number of stools was 4.8 in the treated group and 8.2 in the control group ( = 0.032). We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo.

摘要

口服补液盐(ORS)治疗小儿急性腹泻(AD)有助于降低与脱水相关的死亡率,不过仍需要有效的策略来降低该疾病的发病率。本研究的目的是评估在小儿急性腹泻患者中,联合使用胶体枸橼酸铋钾凝胶(CBHG)和口服补液盐治疗与仅使用ORS治疗相比,腹泻持续时间的变化。我们设计了一项有治疗组和对照组的双盲随机前瞻性研究。纳入年龄在1至12岁、无既往病史且急性腹泻病程小于48小时的患者。使用了卡方检验和曼-惠特尼检验,以及Cox比例风险模型和Kaplan-Meier估计量。患者被随机分为ORS加CBHG治疗组和ORS加安慰剂对照组。(平均年龄:3.2岁)。治疗后评估结果显示,治疗组急性腹泻的平均持续时间为25.5小时,而对照组为41.5小时(P = 0.015)。治疗组的平均排便次数为4.8次,对照组为8.2次(P = 0.032)。我们得出结论,与对照组相比,使用CBHG加ORS显著缩短了急性腹泻的持续时间、减少了排便次数,并降低了治疗24小时后持续性急性腹泻患儿的比例。与接受ORS加安慰剂的患者相比,接受CBHG和ORS治疗的患者急性腹泻缓解速度几乎快了一倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d67a/5184820/5f336436bf8a/children-03-00045-g001.jpg

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