Brodehl J, Krause M, Döhring-Schwerdtfeger E
Kinderklinik der Medizinischen Hochschule Hannover.
Monatsschr Kinderheilkd. 1989 Sep;137(9):578-84.
Parenteral rehydration is mandatory if dehydration is severe, vomiting and anorexia prevails, peristalsis is abolished or consciousness disturbed. It has the aim to prevent a circulatory collapse, to fill up the deficit and maintain the requirement until oral feeding is restarted. The principles of parenteral rehydration did not change during the last 20 years. Initially a rapid infusion of isotonic Ringer's lactate solution is mandatory, which usually is followed by half isotonic Ringer's glucose solution. Hypertonic dehydration should be rehydrated very carefully and slowly. During 1976-1986 212 infants and children with severe dehydration were parenterally rehydrated in the Children's Hospital of Medical School Hannover. Dehydration was isotonic in 65.7%, hypertonic in 20.7%, and hypotonic in 13.6%. The parenteral rehydration lasted from 1 to 7 days and was longer necessary in the hypertonic and hypotonic than isotonic states. 4 infants with hypertonic dehydration showed cerebral complications, and 2 of them died. All other patients recovered quickly without acute sequelae.
如果脱水严重、呕吐和厌食普遍存在、肠蠕动消失或意识障碍，则必须进行胃肠外补液。其目的是预防循环衰竭、补充缺失量并维持所需量，直到重新开始经口喂养。在过去20年中，胃肠外补液的原则没有改变。最初必须快速输注等渗乳酸林格氏液，随后通常是半等渗林格氏葡萄糖溶液。高渗性脱水的补液应非常谨慎且缓慢。1976年至1986年期间，汉诺威医学院儿童医院对212例严重脱水的婴幼儿进行了胃肠外补液。脱水类型为等渗性的占65.7%，高渗性的占20.7%，低渗性的占13.6%。胃肠外补液持续1至7天，高渗性和低渗性状态下所需时间比等渗性状态更长。4例高渗性脱水患儿出现脑部并发症，其中2例死亡。所有其他患者均迅速康复，无急性后遗症。
