复方电解质补给注射液治疗急性肠胃炎并中重度脱水患儿的效果与安全性  

Efficacy and safety of Multiple Electrolytes Supplements Injection for treating acute gastroenteritis children complicated with moderate to severe dehydration

作　　者：黄彩虹[1] 闫凡[1] 贺巧峰 宋君宇 HUANG Cai-hong;YAN Fan;HE Qiao-feng;SONG Jun-yu(Department of Pediatrics,the First Hospital of Yulin,Yulin 719000,China;School of Public Health,Xi′an Jiaotong University,Xi′an 710061,China)

机构地区：[1]陕西省榆林市第一医院小儿科,榆林市719000 [2]西安交通大学公共卫生学院,陕西省西安市710061

出　　处：《广西医学》2021年第3期264-268,274,共6页Guangxi Medical Journal

基　　金：陕西省重点研发计划(2019SF-14232)。

摘　　要：目的观察复方电解质补给注射液治疗急性肠胃炎并中重度脱水患儿的效果与安全性。方法将97例急性胃肠炎并中重度脱水患儿随机分为复方电解质补给注射液组(n=32)、林格组(n=32)及对照组(n=33),分别给予复方电解质补给注射液、乳酸林格液及生理盐水静脉补液。于治疗结束后评价患儿治疗结局,包括主要事件(脱水症状消失)及次要事件(电解质紊乱,静脉补液至口服补液时间、静脉输注液体总量、住院时间、急性肾损伤);于治疗前、治疗后2 h及4 h,采用临床脱水量表(CDS)、改良面部表情疼痛评分量表(FLACC)、呕吐症状量表(BRAF)评价患儿的症状变化情况;治疗前及治疗后4 h检测患儿的血清生化指标及血气分析指标。结果(1)复方电解质补给注射液组主要事件发生率高于其他两组,静脉输注液体总量及住院时间少于其他两组(均P<0.05)。(2)治疗后3组的CDS、FLACC、BRAF评分均较治疗前降低,且复方电解质补给注射液组治疗后2 h及4 h的FLACC评分低于其他两组(均P<0.05)。(3)治疗后4 h,复方电解质补给注射液组及林格组血钙水平较治疗前升高,且血钾、血钙水平高于对照组(P<0.05);3组的血清尿素氮、肌酐及乳酸水平均较治疗前降低,且复方电解质补给注射液组尿素氮和乳酸水平低于其他两组(均P<0.05);复方电解质补给注射液组pH高于治疗前水平及其他两组(P<0.05);3组HCO 3-水平均较治疗前升高,且复方电解质补给注射液组、林格组、对照组HCO 3-水平依次降低(均P<0.05)。结论与乳酸林格液和生理盐水静脉补液相比,复方电解质补给注射液能更有效地缓解急性胃肠炎并中重度脱水患儿的脱水及不适症状,更好地改善患儿酸中毒及肾功能,安全性较好。Objective To observe the efficacy and safety of Multiple Electrolytes Supplements Injection for treating acute gastroenteritis children complicated with moderate to severe dehydration.Methods Ninety-seven acute gastroenteritis children complicated with moderate to severe dehydration were randomly divided into Multiple Electrolytes Supplements Injection group(n=32),Ringer group(n=32)and control group(n=33),receiving intravenous infusion of Multiple Electrolytes Supplements Injection,lactated Ringer′s solution and normal saline,respectively.After treatment,therapeutic outcomes,including major(symptom of dehydration disappeared)and secondary events(electrolyte disturbance,duration from intravenous infusion to oral rehydration therapy,total volume of intravenous fluid infusion,hospital stay,and acute kidney renal),were assessed in the children.Before treatment,two and four hours after treatment,changes in symptoms of the children were evaluated by using the Clinical Dehydration Scale(CDS),the Face,Legs,Activity,Cry,and Consolability Pain Assessment Scale for Infants and Children(FLACC)and the Baxter Animated Retching Faces Scale(BRAF).Serum biochemical indexes and blood gas analysis indexes were determined in the children before treatment and four hours after treatment.Results(1)The Multiple Electrolytes Supplements Injection group had a higher incidence rate of major events,less total volume of intravenous infusion,and shorter hospital stay than the other two groups(all P<0.05).(2)The scores of CDS,FLACC and BRAF after treatment were lower than the pre-therapeutic scores in the three groups,and the Multiple Electrolytes Supplements Injection group yielded lower FLACC scores two and four hours after treatment than the other two groups(all P<0.05).(3)Four hours after treatment,the Multiple Electrolytes Supplements Injection and Ringer groups obtained a higher blood calcium level as compared with the pre-therapeutic,and also exhibited higher blood potassium and calcium levels than the control group(all P<0.05);the le

关 键 词：急性肠胃炎 中重度脱水 复方电解质补给注射液 临床效果 安全性 

分 类 号：R573.3[医药卫生—消化系统]