Seas C, DuPont H L, Valdez L M, Gotuzzo E
Universidad Peruana Cayetano Heredia, Lima, Peru.
Drugs. 1996 Jun;51(6):966-73. doi: 10.2165/00003495-199651060-00005.
Cholera is a dramatic clinical illness that requires rapid diagnosis and aggressive therapy. Clinical signs and symptoms of mild, moderate and severe dehydration must be determined, before beginning fluid therapy. Fluid therapy has 2 phases: rehydration (first 3 to 4 hours to correct deficits) and maintenance (to match continuing losses). The route and speed of fluid administration will depend on the degree of dehydration. Patients with severe dehydration should be treated intravenously, as should those patients who do not tolerate oral rehydration solution (ORS). Ringer's lactate is the preferred intravenous solution, although normal saline may be used along with ORS. For most patients with cholera, an ORS using one of the higher sodium-containing solutions and plain water optimally provide the fluid and salt needed. Close monitoring of intake, outputs and hydration status should be performed for all patients. Antimicrobial therapy should be given to moderately and severely ill patients in order to decrease the volume of fluids lost and to shorten the period of excretion of vibrios.
霍乱是一种严重的临床疾病，需要快速诊断和积极治疗。在开始液体治疗前，必须确定轻度、中度和重度脱水的临床体征和症状。液体治疗有两个阶段：补液（最初3至4小时纠正缺水）和维持（补充持续丢失的液体）。液体给药的途径和速度将取决于脱水程度。重度脱水患者应静脉治疗，不能耐受口服补液盐（ORS）的患者也应如此。乳酸林格液是首选的静脉溶液，不过生理盐水也可与ORS一起使用。对于大多数霍乱患者，使用含钠量较高的溶液之一和白开水的ORS能最佳地提供所需的液体和盐分。应对所有患者密切监测摄入量、排出量和水合状态。中度和重度患病患者应接受抗菌治疗，以减少液体丢失量并缩短弧菌排泄期。
