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[急性腹泻婴儿的口服补液:使用一种新的低渗制剂]

[Oral rehydration in infants with acute diarrhea: using a new preparation of reduced osmolarity].

作者信息

Lentidoro I, Anastasio E, Pensabene L, Apollini M, Guandalini S

机构信息

Cattedra di Pediatria, Università di R.C., Facoltà di Medicina di Catanzaro, Italia.

出版信息

Pediatr Med Chir. 1996 Jan-Feb;18(1):67-9.

PMID:8685028
Abstract

Oral rehydration solutions (ORS) are widely employed in the treatment of acute diarrhea in children. Although several studies in the recent literature prove the efficacy and safety of newly formulated, reduced-osmolarity solutions, and a specific working group of the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN) has made similar recommendations, such evidence in our Country is lacking. To this aim, we enrolled 38 children (age from 3 to 24 months, average: 8.2) with acute diarrhea lasting from no more than 5 days (average: 2.5). At observation, dehydration was found to be: absent in 12 (31.6%), mild in 19 (50%), moderate in 5 (13.2%), severe in 2 (5.2%). The last 2 patients were admitted and treated i.v., thus excluded from the study. In the 36 remaining children, a pathogen was identified in 25 (69.4%): Rotavirus in 18, Salmonella in 4, EPEC in 2, Cryptosporidium in 1. Stool Clinitest was positive in 7/31 children, all with Rotavirus infection. All the patients received ad libitum for the first 4-6 hours exclusively a reduced-osmolarity ORS formulated according to the ESPGAN criteria. Afterwards, they were fully re-fed and were also given the same ORS until diarrhea stopped. Most of the children accepted the ORS; those who refused it were either not dehydrated and/or older than 15 months. Thirty-three out of 36 children were fully rehydrated after 12 hours, without any side effects. We conclude that such an ORS is safe and effective in the treatment of children with acute diarrhea in our settings.

摘要

口服补液盐(ORS)被广泛用于治疗儿童急性腹泻。尽管最近文献中的多项研究证明了新配方的低渗溶液的有效性和安全性,并且欧洲儿科胃肠病学和营养学会(ESPGAN)的一个特定工作组也提出了类似建议,但我国缺乏此类证据。为此,我们纳入了38名年龄在3至24个月(平均8.2个月)的儿童,他们患有持续不超过5天(平均2.5天)的急性腹泻。观察发现,脱水情况为:12名(31.6%)无脱水,19名(50%)轻度脱水,5名(13.2%)中度脱水,2名(5.2%)重度脱水。最后2名患者入院接受静脉治疗,因此被排除在研究之外。在其余36名儿童中,25名(69.4%)检测出病原体:轮状病毒18例,沙门氏菌4例,肠致病性大肠杆菌2例,隐孢子虫1例。31名儿童中有7名粪便Clinitest检测呈阳性,均为轮状病毒感染。所有患者在最初4至6小时内随意饮用一种根据ESPGAN标准配制的低渗ORS。之后,他们完全恢复正常饮食,并继续饮用相同的ORS直至腹泻停止。大多数儿童接受了ORS;拒绝饮用的儿童要么没有脱水,要么年龄超过15个月。36名儿童中有33名在12小时后完全补液,且无任何副作用。我们得出结论,在我们的环境中,这种ORS在治疗儿童急性腹泻方面是安全有效的。

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