Meeuwisse G W
Acta Paediatr Scand. 1983 Mar;72(2):161-6. doi: 10.1111/j.1651-2227.1983.tb09689.x.
The literature on oral sugar-electrolyte mixtures for treatment of acute diarrhoea is reviewed. Several trials have shown that the solution proposed by the WHO for developing countries containing inter alia 90 mmol/l of sodium and 111 mmol/l of glucose is safe for short term oral rehydration. When used in this manner there is no risk for development of hypernatraemia. The surplus base of the solution is not essential and, furthermore, other anions e.g. acetate may be substitute for bicarbonate. Other modifications of the WHO formula have also been successfully tried, e.g. sucrose 4% (117 mmol/l) instead of glucose 2% (111 mmol/l). A somewhat lower concentration of sucrose may, however, prove to be better. Most acute childhood diarrhoeas are not mediated by enterotoxin and thus not of the secretory type, but temporary malabsorption is common. Therefore, the amount of carbohydrate in oral sugar-electrolyte mixtures should be limited. Osmotic diarrhoea due to carbohydrate malabsorption is a more likely cause of hypernatraemia in dehydrated children than too much dietary sodium. In developed countries prepacked oral sugar-electrolyte mixtures are mainly designed for moderately sick children treated at home. There is no reason to raise the carbohydrate content of these mixtures above that of the WHO formula, but the sodium content must be lower. For most situations in home treatment 50 mmol/l of sodium will be adequate.
本文综述了关于口服糖电解质混合物治疗急性腹泻的文献。多项试验表明，世界卫生组织为发展中国家推荐的溶液，其中钠含量为90 mmol/L，葡萄糖含量为111 mmol/L，用于短期口服补液是安全的。以这种方式使用时，不会有发生高钠血症的风险。该溶液中的多余碱并非必需，此外，其他阴离子如乙酸盐可替代碳酸氢盐。世界卫生组织配方的其他改良方法也已成功尝试，例如用4%（117 mmol/L）的蔗糖替代2%（111 mmol/L）的葡萄糖。然而，稍低浓度的蔗糖可能效果更好。大多数儿童急性腹泻并非由肠毒素介导，因此不是分泌型腹泻，但暂时性吸收不良很常见。因此，口服糖电解质混合物中的碳水化合物含量应受到限制。与过多的膳食钠相比，碳水化合物吸收不良导致的渗透性腹泻更可能是脱水儿童发生高钠血症的原因。在发达国家，预包装口服糖电解质混合物主要是为在家中治疗的中度患病儿童设计的。没有理由将这些混合物中的碳水化合物含量提高到超过世界卫生组织配方的水平，但钠含量必须更低。对于家庭治疗中的大多数情况，50 mmol/L的钠含量就足够了。
