急性轮状病毒性肠炎并高渗血症的临床特征分析

Clinical Characteristic Analysis of Child's Acute Rotavirus Enteritis with Blood Hyperosmolality

【目的】探讨小儿急性轮状病毒肠炎并高渗血症的临床特点及治疗对策。【方法】回顾性分析43例急性轮状病毒肠炎并发高渗血症患儿的临床特点、液体疗法及疗效。【结果】43例中单纯高钠性高渗血症占65.12%,单纯高糖性高渗血症占4.65%,高钠伴高糖性高渗血症占30.23%,;发病年龄在1岁内占90.7%,在血渗透压>330 mmol/L组<6个月的小婴儿占63.6%。对生存组和死亡组的治疗中不同的血钠下降速度与疗效作了比较,在血渗透压≤330 mmol/L组中无显著差异(P>0.05);而在血渗透压>330 mmol/L组中较快降低血渗透压易诱发脑水肿和增加病死率(P<0.05)。【结论】急性轮状病毒肠炎高渗血症的特点是发生年龄小,尤其是<6个月的小婴儿病情重、起病急、病程短;以单纯高钠性高渗血症为主,其次是高钠并高糖性高渗血症。可根据血渗透压升高的不同程度采用不同方式来控制血钠下降的速度是治疗成功的关键,同时应兼顾高血糖及高热的合理处理。

[Objective]To study the clinical characteristics and the treatment of child＇s acute rotavirus enteritis with blood hyperosmolality. [Methods]Clinical materials of child＇s acute rotavirus enteritis were reviewed. The relationship between the clinical characteristics and and the result of liquid treatment in 43 children with blood hyperosmolality were analysed. [Results]In the group of the blood hyperosmolality, the incidence of simple high blood sodium was 65.12 %, simple high blood sugar was 4.65 %. , both high blood sodium and sugar was 30.23 %. The incidence was 90.7 % when children＇s age was within one year old. The incidence was 63.6 %. when small baby＇s age was within 6 months,and their blood osmosis pressure was over 330mmol/ L. Different blood sodium decreasing speed and the the result of treatment were compared between the survived group and the died group, there was no remarkable relationship in the group when their blood osmosis pressure was less than 330mmol/L（ P〉0.05） ;but the incidence of brain edema and death was increased in the group when their blood osmosis pressure was over 330mmol/L（ P 〈0.05）. [Conclusion]The characteristics of acute rotavirus enteritis with blood hyperosmolality is that the illness age is low, especially within 6 months, the condition may be serious,and urgent with short course in the small babies . In blood hyperosmolality , the simple high sodium is the main cause, both high blood sodium and sugar are the second one. It is the key to treat successfully the different degree of blood hyperosmolality according to different degree of blood osmosis pressure and give consideration to the rational treatment of the high blood sugar and high fever at the same time.