Marin L, Günoz H, Sökücü S, Saner G, Aperia A, Neyzi O, Zetterström R
Acta Paediatr Scand. 1986 May;75(3):477-82. doi: 10.1111/j.1651-2227.1986.tb10233.x.
The clinical response and changes in water and salt homeostasis was studied for 36 hours during oral rehydration therapy with a rehydration solution containing 60 mmol sodium/l (ORS60) in 14 malnourished 3- to 15-month-old Turkish infants with acute infectious diarrhoea. All patients were successfully rehydrated with this treatment. Sodium was efficiently absorbed from the gut and water balance was rapidly restored. Because of excess fluid retention following the initial rehydration period about 50% of the patients became oedematous. Urine volume and urinary sodium excretion were found to be much lower than in well-nourished patients of the same age with acute diarrhoea who were treated in the same way. In all of the malnourished infants the serum sodium level remained within the normal range during treatment. The results show that malnourished infants retain much more fluid and sodium than infants who are in a normal nutritional state. Excessive retention of water and salt seem to be due to an inability of the kidneys to control sodium and fluid homeostasis while orally administered sodium and fluid are being absorbed from the gut. The results show that ORT is safe and efficient in the treatment of malnourished infants with acute diarrhoea. But since these infants run a high risk of developing a severe retention of fluid and salt, and consequently may develop circulatory failure due to hypervolaemia during oral rehydration therapy, it is important to carefully monitor the volume of fluid that is given.
对14名患有急性感染性腹泻的3至15个月大的土耳其营养不良婴儿，使用含钠量为60 mmol/L的口服补液溶液（ORS60）进行口服补液治疗，研究其临床反应以及水盐稳态的变化情况，为期36小时。所有患者经此治疗均成功实现补液。钠从肠道有效吸收，水平衡迅速恢复。由于初始补液期后液体潴留过多，约50%的患者出现水肿。发现尿量和尿钠排泄量远低于以同样方式治疗的同龄急性腹泻营养良好的患者。在所有营养不良婴儿中，治疗期间血清钠水平保持在正常范围内。结果表明，营养不良婴儿比营养状态正常的婴儿潴留更多的液体和钠。水盐潴留过多似乎是由于在肠道吸收口服给予的钠和液体时，肾脏无法控制钠和液体的稳态。结果表明，口服补液疗法治疗营养不良婴儿急性腹泻安全有效。但由于这些婴儿发生严重液体和盐潴留的风险很高，因此在口服补液治疗期间可能因血容量过多而发生循环衰竭，所以仔细监测给予的液体量很重要。
