Gugler E
Medizinische Universitäts-Kinderklinik, Inselspital Bern.
Ther Umsch. 1994 Sep;51(9):616-21.
The acute loss of fluids and electrolytes in children can result in critical situations of emergency. Infants and young children are at particular risk for these events. The main cause of dehydration in this age group is acute diarrheal disease. A careful history and the clinical signs allow an approximative estimation of the severity of the fluid loss. The type of dehydration is determined by the measurement of the sodium concentration in blood. The isonatremia type is the most common one and is present in 70% of all children with dehydration. The fluid therapy consists in restoring the deficits of water and electrolytes, in covering the basic needs and in replacing the continuing losses. The oral rehydration with appropriate glucose-electrolytes solutions, which are commercially available, is very effective in mild and moderate dehydration. This method allows a rapid rehydration and will markedly reduce the number of hospitalizations; furthermore, a prompt refeeding (realimentation) within 24 hours is possible. The parenteral rehydration for certain moderate and for severe forms is reserved to treatment in a hospital or an emergency department. The practical proceeding of both types of rehydration is described.
儿童体液和电解质的急性丢失可导致危急的紧急情况。婴幼儿尤其容易发生这些情况。该年龄组脱水的主要原因是急性腹泻病。详细的病史和临床体征有助于大致估算体液丢失的严重程度。脱水类型通过测定血钠浓度来确定。等渗性脱水是最常见的类型，在所有脱水儿童中占70%。液体疗法包括补充水和电解质的缺失、满足基本需求以及补充持续丢失的量。使用市售的合适葡萄糖电解质溶液进行口服补液，对轻度和中度脱水非常有效。这种方法能快速补液，并将显著减少住院人数；此外，还可在24小时内迅速进行重新喂养（再喂养）。对于某些中度和重度脱水情况，肠外补液则需在医院或急诊科进行治疗。文中描述了两种补液方式的实际操作过程。
