Newton C R, Gonvers J J, McIntyre P B, Preston D M, Lennard-Jones J E
J R Soc Med. 1985 Jan;78(1):27-34. doi: 10.1177/014107688507800106.
The effectiveness of 5 different solutions on the absorption of fluid and electrolytes was tested in 7 patients with a proximal intestinal stoma and large fluid losses, all of whom previously needed intravenous infusions to maintain balance. In 4 patients it proved possible to replace the intravenous infusions with an enteral supplement. The WHO glucose/electrolyte solution without added potassium (NaCl 3.5 g, NaHCO3 2.5 g, glucose 20 g/l) gave satisfactory results, though was slightly less effective than a solution containing more sodium in which maltose was substituted for glucose. Neither sucrose nor an oligosaccharide (Caloreen) gave an advantage over glucose in the formulations used. In 3 patients losses were so great, and absorption of sodium from oral solutions so small, that intravenous supplements had to be continued. These 3 patients could be distinguished from the other 4 by the fact that more than 250 ml emerged from the stoma during the 3 hours after a drink of 500 ml of glucose/electrolyte solution. In all patients a drink of water or tea led to a loss of sodium from the stoma; water should be restricted in such patients and replaced by a glucose/electrolyte solution.
对7例近端肠造口且有大量液体丢失、之前均需静脉输液以维持平衡的患者,测试了5种不同溶液对液体和电解质吸收的效果。4例患者证明可用肠内补充剂替代静脉输液。不含钾的世界卫生组织葡萄糖/电解质溶液(氯化钠3.5 g、碳酸氢钠2.5 g、葡萄糖20 g/l)取得了满意结果,不过比含更多钠且用麦芽糖替代葡萄糖的溶液效果稍差。在所使用的配方中,蔗糖和一种低聚糖(卡洛林)均未比葡萄糖表现出优势。3例患者的液体丢失量极大,口服溶液中钠的吸收极少,因此必须继续进行静脉补充。这3例患者与其他4例的区别在于,饮用500 ml葡萄糖/电解质溶液后3小时内,造口处流出的液体超过250 ml。所有患者饮水或茶后均导致造口处钠流失;此类患者应限制饮水,并用葡萄糖/电解质溶液替代。