Steiner N, Bruera E
Palliative Care Program, Grey Nuns Community Hospital and Health Centre, Edmonton, Alberta, Canada.
J Palliat Care. 1998 Summer;14(2):6-13.
A strong and often polarized debate has taken place during recent years concerning the consequences of dehydration in the terminally ill patient. When a patient has a severely restricted oral intake or is found to be dehydrated, the decision to administer fluids should be individualized and made on the basis of a careful assessment that considers problems related to dehydration, potential risks and benefits of fluid replacement, and patients' and families' wishes. This review discusses the assessment of hydration status in the terminal cancer patient and the options for fluid administration in the cases where evaluation of the patients' condition has led to this indication. These include different modes of hypodermoclysis, intravenous hydration, use of the nasogastric route, and proctoclysis. Arguments for and against rehydration have been previously addressed by other authors and fall outside the scope of this review.
近年来，关于晚期患者脱水的后果展开了一场激烈且往往两极分化的辩论。当患者口服摄入量严重受限或被发现脱水时，给予补液的决定应个体化，并基于仔细评估做出，该评估要考虑与脱水相关的问题、补液的潜在风险和益处以及患者及其家属的意愿。本综述讨论了晚期癌症患者水化状态的评估，以及在患者病情评估得出此指征的情况下的补液选择。这些选择包括不同的皮下输液方式、静脉补液、鼻胃管途径的使用以及直肠滴注。其他作者之前已经讨论过支持和反对补液的论点，不在本综述范围内。
