Ellershaw J E, Sutcliffe J M, Saunders C M
St. Christopher's Hospice, London, England.
J Pain Symptom Manage. 1995 Apr;10(3):192-7. doi: 10.1016/0885-3924(94)00123-3.
This study investigated the relationship between symptoms and dehydration in 82 subjects with malignant disease. Assessment of respiratory tract secretions, thirst, and dry mouth were made during the dying phase, and serum biochemistry was analyzed. Follow-up data were also collected when the patient died. The median time from entry into the study until death was 2 days. All subjects died without artificial fluid therapy. Analysis showed that over 50% of subjects had a serum osmolality of less than 295 mOsm/kg. Contrary to previous anecdotal evidence, no statistically significant relationship was demonstrated between the level of hydration and respiratory tract secretions. Twenty-eight percent of subjects were able to respond to questions; 87% of these had a dry mouth and 83% felt thirsty. No statistically significant association was found between level of hydration and these symptoms. Artificial hydration to alleviate these symptoms in the dying patient may, therefore, be futile. Further work needs to be carried out regarding the cause and treatment of these symptoms in the dying patient.
本研究调查了82例恶性疾病患者的症状与脱水之间的关系。在濒死期评估呼吸道分泌物、口渴和口干情况，并分析血清生化指标。患者死亡时也收集随访数据。从进入研究到死亡的中位时间为2天。所有受试者均未接受人工补液治疗而死亡。分析表明，超过50%的受试者血清渗透压低于295 mOsm/kg。与之前的轶事证据相反，未发现水化水平与呼吸道分泌物之间存在统计学上的显著关系。28%的受试者能够回答问题；其中87%口干，83%感到口渴。未发现水化水平与这些症状之间存在统计学上的显著关联。因此，通过人工补液来缓解濒死患者的这些症状可能是徒劳的。需要针对濒死患者这些症状的病因和治疗开展进一步研究。
