低渗口服补液盐治疗儿童腹泻所致脱水的Meta分析

Meta-analysis of reduced osmolarity oral rehydration solution in treating dehydration due to diarrhoea in children

目的系统评价低渗口服补液盐(ORS)和标准ORS治疗儿童腹泻所致脱水的疗效和安全性。方法计算机检索2014年11月前国内外数据库有关低渗ORS和标准ORS治疗儿童腹泻所致脱水的随机对照实验(RCT),对纳入的研究进行方法学评价后,采用Rev Man 5.3软件对纳入的文献进行Meta分析。结果共纳入24个RCT,合计3236例患者。Meta分析结果显示,使用低渗ORS和标准ORS治疗儿童腹泻所致脱水过程中静脉补液发生率(RR=0.76,95%CI:0.59~0.99,P<0.05)和排便量(SMD=-0.53,95%CI:-0.84^-0.21,P<0.05),差异有统计学意义。使用低渗ORS和标准ORS治疗儿童腹泻所致脱水过程中呕吐发生率(RR=0.89,95%CI:0.79~1.00,P≥0.05)和低钠血症发生率(RR=1.30,95%CI:0.90~1.87,P≥0.05),差异无统计学意义。结论低渗ORS治疗儿童腹泻所致脱水过程中能有效减少静脉补液发生率和患儿排便量,并不增加呕吐和低钠血症的发生率。

jObjective To compare the efficacy and safety of reduced osmolarity oral rehydration solution （ORS） andstandard oral rehydration solution in the treatment of dehydration due to diarrhoea in children. Methods Randomizedcontrolled trial （RCT） was made from computer retrieval database before November 2014 both at home and abroad aboutthe reduced osmolarity oral rehydration solution and standard osmolarity oral rehydration solution in treating childrenwith diarrhea causing dehydration, after being incorporated into the research by methodology of evaluation, RevMan 5.3software was used for Meta-analysis. Results Totally 24 RCT were included, 3236 patients. Meta-analysis resultsshowed that in the use of reduced osmolarity ORS and standard ORS in the treatment of children with diarrhea, un-planned intravenous rehydration rate （RR = 0.76, 95% CI： 0.56 -0.99, P〈0.05） and the amount of defecation（SMD=- 0.53,95% CI= 0.84 - 0.21, P 〈 0.05） , had statistically significant difference. Incidence rate of vomiting（RR = 0.89, 95%CI： 0.79- 1.00, P〈0.05） and incidence rate of hyponatremia （RR = 1.30, 95%CI： 0.90-1.87, P〉0.05） had no statistically significant diference. Conclusion Reduced osmolarity ORS treatment can effectively reducethe unplanned intravenous rehydration rate and the amount of defecation in the treatment of children with diarrhea caus-ing dehydration, which does not increase the incidence rate of vomiting and hyponatremia.