Brady KeriAnne
Director of Pediatric Emergency Medicine Education, Attending Physician, Department of Emergency Medicine, New York-Presbyterian/Queens; Instructor of Emergency Medicine in Clinical Pediatrics, Weill Cornell Medical College, New York,NY.
Pediatr Emerg Med Pract. 2018 Feb;15(2):1-24. Epub 2018 Feb 1.
Although most cases of acute gastroenteritis require minimal medical intervention, severe dehydration and hypoglycemia may develop in cases of prolonged vomiting and diarrhea. The mainstay of treatment for mild-to-moderately dehydrated patients with acute gastroenteritis should be oral rehydration solution. Antiemetics allow for improved tolerance of oral rehydration solution, and, when used appropriately, can decrease the need for intravenous fluids and hospitalization. This issue reviews the common etiologies of acute gastroenteritis, discusses more-severe conditions that should be considered in the differential diagnosis, and provides evidence-based recommendations for management of acute gastroenteritis in patients with mild-to-moderate dehydration, severe dehydration, and hypoglycemia.
虽然大多数急性胃肠炎病例只需极少的医疗干预,但长时间呕吐和腹泻的病例可能会出现严重脱水和低血糖。对于轻度至中度脱水的急性胃肠炎患者,治疗的主要方法应是口服补液溶液。止吐药可提高对口服补液溶液的耐受性,并且在适当使用时,可减少静脉输液和住院的需求。本期专题回顾了急性胃肠炎的常见病因,讨论了鉴别诊断中应考虑的更严重情况,并为轻度至中度脱水、严重脱水和低血糖患者的急性胃肠炎管理提供了循证建议。