Pargger H, Scheidegger D
Departement Anästhesie, Kantonsspital Basel.
Schweiz Rundsch Med Prax. 1993 Jul 20;82(29-30):795-9.
Rehydration of terminally ill patients is from a technical point of view not more difficult than fluid treatment of any other patient. The difficulty lies in the balanced decision between the appropriate method on one hand and the desirability of a rehydration on the other hand. The route of choice in terms of burden for the patient as well as from a logistic point of view is the oral one. If it fails fluid can be administered via transnasal gastric tube. Percutaneous endoscopic gastrostomy and other types of gastrostomy do not provide any advantage over gastric tube for patients with imminent early mortality and those in a hospital. Subcutaneous infusions provide at least for a short time a suitable method for rehydration also and in particular for terminally ill patients. Peripheral venous catheters are suitable for rehydration, however only for a period of few days until another solution is found.
从技术角度来看,对绝症患者进行补液并不比治疗其他患者更困难。困难在于一方面要在合适的方法与补液的必要性之间做出平衡的决策。从对患者的负担以及后勤角度来看,首选的途径是口服。如果口服失败,可以通过鼻胃管进行补液。对于临近早期死亡的患者以及住院患者,经皮内镜下胃造口术和其他类型的胃造口术相比胃管并没有任何优势。皮下输注至少在短时间内也是一种合适的补液方法,尤其适用于绝症患者。外周静脉导管适用于补液,但仅能维持几天,直到找到其他解决方案。