41例营养不良儿腹泻伴水、电解质紊乱的抢救

Emergency Treatment for 41 Dystrophic Infants With Diarrhea Accompanied by Water and Electrolytes Disturbance

收治营养不良腹泻伴脱水、电解质紊乱的患儿４１例，其中Ａ组共２６例，采用传统治疗方案抢救。结果：治愈１８例，自动出院１例，死亡７例。Ｂ组共１５例，在原方案基础上进行改良，即首批等张含钾液２０ｍｌ／ｋｇ（２份生理盐水：１份血浆＋０．３％浓度钾）１／２～１ｈ内滴入，继接２／３张含多巴胺液，以５～８μｇ／ｋｇ·ｍｉｎ－１的速度维持补液。结果：治愈１４例，死亡１例。两组死亡率经Ｕ检验比较，Ｐ＜０．０５。我们认为营养不良儿腹泻伴脱水、电解质紊乱，尤其伴有低钾危象的抢救，着重在于迅速建立有效的血液循环，维护心肾功能，早期补钾，后续用碱性溶液，会提高抢救成功率。

Forty-one inpatients of dystrophic infants with diarrhea accompanied by water and electrolytes disturbance were divided into 2 groups:26 patients in A group were treated with traditional method,18 cured,one was dismissed of his own accord and 7 died.15 patients in B group were treated with modified original scheme,i.e.initial:isotonic solution with potassium(normal saline 2 portions:blood plasma 1 portion+0.3% potassium)20ml/kg i.v.drip within 1/2～1h.and then followed by 2/3 tonic solution contained dopamine solution with the velocity of 5～8 μg/kg/min -1 to maintain fluid infusion.Results:14 patients cured,1 died.The mortality of both groups compared with u test showed P <0.05.It is considered that the emergency treatment for dystrophic infants accompanied by dehydration and electrolytes disturbance,especially associated with hypokalemic crisis should emphasize to set up rapidly the effeetive blood circulation,maintain the function of heart and lungs,replenish potassium at the early stage and then give alkaline solution,thus the successful rate of emergency treatment may be elevated.