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运动后的补液:饮用白开水与等渗口服补液盐溶液(ORS)的效果比较

Rehydration following exercise: effects of administration of water versus an isotonic oral rehydration solution (ORS).

作者信息

Marlin D J, Scott C M, Mills P C, Louwes H, Vaarten J

机构信息

Centre for Equine Studies, Animal Health Trust, Kentford, Newmarket, Suffolk, UK.

出版信息

Vet J. 1998 Jul;156(1):41-9. doi: 10.1016/s1090-0233(98)80060-9.

Abstract

The effects of administering (1) 6L isotonic oral rehydration solution (ORS), similar in composition to plasma (except for an elevated potassium concentration) and with an osmotic skeleton and (2) 6L water (no osmotic skeleton), were evaluated in five thoroughbred horses following exercise-induced dehydration. The horses were exercised on a treadmill for 10 min at walk (1.7 m.s-1; approximately 15% VO2max), 40 min at trot (3.7 m.s-1; approximately 25% VO2max) and 10 min at walk (1.7 m.s-1; approximately 15% VO2max). Exercise was undertaken on a 3 degrees incline at 30 degrees C/80% RH. Solutions of water or ORS at 20 degrees C were administered by nasogastric tube over 60s 5 min following exercise. Mean weight loss following exercise was 9.2 +/- 1.7 kg (2.0 +/- 0.4% body weight; mean +/- SEM) with water and 9.2 +/- 1.1 kg (2.0 +/- 0.2% body weight) with ORS and was not different between treatments (P > 0.05). Water treatment resulted in a fall in plasma [Na+] (approximately 3 mmol.L-1) and C1- (1-2 mmol.L-1) concentrations by 30 min after administration and the effect persisted until the end of the study (300 min post fluids). There was little change in plasma total protein (TP) from that at the end of exercise, suggesting a failure of water to restore or maintain PV. In contrast, ORS administration resulted in a small increase in plasma [Na+] (1-2 mmol.L-1) and [Cl-] (2-3 mmol.L-1) with a corresponding decrease in plasma TP. By 120 min post ORS, plasma TP and PV were no longer significantly different from rest or pre-exercise (P > 0.05), whilst with water, TP was elevated (approximately 3-4 g.L-1) and PV reduced (approximately 4-5 mL.kg-1). Total urine output was not significantly different between water (1096 +/- 135 mL) and ORS (750 +/- 215 mL, P > 0.05). Estimates of expected plasma volume and electrolyte concentration changes as a result of either treatment compared well with measured changes of TP and PV. On the basis of calculated or measured changes, it was estimated that only 1L of water contributed to rehydration following exercise compared to 4L isotonic, plasma-like ORS. The administration of 6L ORS restored the PV deficit induced by exercise with minimal or no disturbance of plasma electrolyte concentrations. In contrast, water alone resulted in minimal improvement in PV. When fluid intake after periods of fluid loss, such as induced by exercise or transport, is not accompanied by food intake, the present study has clearly demonstrated that water alone is ineffective in promoting rehydration compared with an isotonic, plasma-like ORS.

摘要

在五匹纯种马运动性脱水后,评估了给予(1)6升等渗口服补液盐(ORS)(其成分与血浆相似,除钾浓度升高外,且具有渗透骨架)和(2)6升水(无渗透骨架)的效果。马匹在跑步机上以步行速度(1.7米/秒;约为最大摄氧量的15%)运动10分钟,以小跑速度(3.7米/秒;约为最大摄氧量的25%)运动40分钟,然后再以步行速度(1.7米/秒;约为最大摄氧量的15%)运动10分钟。运动在30℃/80%相对湿度的3度斜坡上进行。运动后5分钟内,通过鼻胃管在60秒内给予20℃的水或ORS溶液。运动后平均体重减轻,给予水时为9.2±1.7千克(占体重的2.0±0.4%;平均值±标准误),给予ORS时为9.2±1.1千克(占体重的2.0±0.2%),两种处理之间无差异(P>0.05)。给予水处理后30分钟,血浆[Na⁺](约3毫摩尔/升)和[Cl⁻](1 - 2毫摩尔/升)浓度下降,且该效应持续至研究结束(补液后300分钟)。血浆总蛋白(TP)与运动结束时相比变化不大,表明水未能恢复或维持血浆容量(PV)。相比之下,给予ORS导致血浆[Na⁺](1 - 2毫摩尔/升)和[Cl⁻](2 - 3毫摩尔/升)略有增加,同时血浆TP相应降低。ORS给药后120分钟,血浆TP和PV与休息或运动前相比不再有显著差异(P>0.05),而给予水时,TP升高(约3 - 4克/升),PV降低(约4 - 5毫升/千克)。水组(1096±135毫升)和ORS组(750±215毫升)的总尿量无显著差异(P>0.05)。两种处理导致的预期血浆容量和电解质浓度变化估计值与测量的TP和PV变化情况相符。根据计算或测量的变化估计,运动后仅有1升水有助于补液,而等渗、类似血浆的ORS为4升。给予6升ORS可恢复运动引起的PV不足,且对血浆电解质浓度的干扰最小或无干扰。相比之下,仅给予水对PV的改善极小。当在诸如运动或运输引起的液体丢失后进行液体摄入且不伴有食物摄入时,本研究清楚地表明,与等渗、类似血浆的ORS相比,仅给予水在促进补液方面无效。

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