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[儿童急性肠胃炎的管理]

[Management of acute gastroenteritis in children].

作者信息

Wielgos Katarzyna, Setkowicz Wioletta, Pasternak Gerard, Lewandowicz-Uszyńska Aleksandra

机构信息

Department of Paediatrics, J. Gromkowski Regional Specialist Hospital in Wroclaw, Poland.

3rd Department and Clinic of Paediatrics, Immunology and Rheumatology of Developmental Age, Wroclaw Medical University, Poland; Department of Immunology and Paediatrics, J. Gromkowski Regional Specialist Hospital in Wroclaw; Poland.

出版信息

Pol Merkur Lekarski. 2019 Aug 30;47(278):76-79.

Abstract

Acute gastroenteritis is one of the most common infection among children. An estimated 500 million children suffer from the condition worldwide each year. In developed countries the course of acute infectious diarrhea is relatively mild, symptoms usually resolve spontaneously within few days. Unfortunately high mortality rate is still a heavyweight problem in countries with low economic development. Acute diarrhea is defined as a change of the consistency of stools to loose or liquid and/ or increase of an amount of defecations to more than 3 during a day. Other symptoms of gastroenteritis include fever, nausea and vomiting. The most common cause of AGE are viruses, with rotavirus being the most frequent agent. The diagnose is based on medical interview, that include mainly precise information about duration and characteristic of occurred symptoms and epidemiological data. The most important part of diagnostic and therapeutic management is dehydration's assessment, which determine the severity of AGE and is used as one of the factors that decide about hospital admission. The majority of patients can be treated in an outpatients settings, hospitalization should be reserved for those requiring enteral or parenteral rehydration. Oral rehydration with hypoosmolar fluids is standard first-line treatment. Other effective procedures include administration of probiotics (Lactobacillus GG , Saccharomyces boulardii), racecadotril and diosmectite as antidiarrheals and ondansetron reducing the intensity of nausea and vomiting. Antibiotherapy should be only considered in exceptional situations. Acute diarrhea is commonly known medical problem, which can be easily treated by following simple, well-defined rules.

摘要

急性肠胃炎是儿童中最常见的感染性疾病之一。据估计,全球每年有5亿儿童受此疾病困扰。在发达国家,急性感染性腹泻病程相对较轻,症状通常在数天内自行缓解。不幸的是,在经济欠发达国家,高死亡率仍是一个严重问题。急性腹泻定义为大便质地变为稀便或水样便和/或排便次数增加至一天超过3次。肠胃炎的其他症状包括发热、恶心和呕吐。急性肠胃炎最常见的病因是病毒,其中轮状病毒最为常见。诊断基于医学问诊,主要包括关于症状持续时间和特征的准确信息以及流行病学数据。诊断和治疗管理中最重要的部分是脱水评估,它决定了急性肠胃炎的严重程度,并作为决定是否住院的因素之一。大多数患者可在门诊治疗,需要肠内或肠外补液的患者应住院治疗。使用低渗液进行口服补液是标准的一线治疗方法。其他有效措施包括使用益生菌(鼠李糖乳杆菌GG、布拉酵母菌)、消旋卡多曲和蒙脱石作为止泻药,以及使用昂丹司琼减轻恶心和呕吐的程度。抗生素治疗仅在特殊情况下考虑。急性腹泻是常见的医学问题,遵循简单、明确的规则即可轻松治疗。

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