不同剂量口服补液盐Ⅲ治疗儿童神经介导性晕厥疗效及对血清电解质的影响

Different Doses of Oral Rehydration SaltsⅢin the Treatment of Children with Neurally Mediated Syncope and Its Effects on Serum Electrolytes

目的:探讨不同剂量口服补液盐(ORS)Ⅲ治疗儿童神经介导性晕厥(NMS)疗效及对血清电解质的影响。方法:回顾性分析2016年1月至2019年3月在我院确诊并接受治疗的NMS儿童,收集患儿年龄、性别,初诊时血清钠、血清钾、血清氯、血清磷、血清钙离子及直立倾斜试验(HUTT)检查结果,随访治疗及转归情况。根据治疗过程中口ORS不同剂量分为ORS 500 mL/d组及ORS不限量组。应用SPSS 21.0软件,组间比较采用χ^(2)检验,组内治疗前后比较采用配对t检验。结果:ORS不限量组与ORS 500 mL/d组有效率比较差异有统计学意义(90.9%vs 66.3%,χ^(2)=3.77,P<0.05),ORS不限量组与ORS 500 mL/d组HUTT转阴率比较差异有统计学意义(72.2%vs 40.0%,χ^(2)=4.68,P<0.05)。ORS不限量组治疗效果佳,症状改善明显。不同剂量ORS组治疗后血清电解质钠离子水平上升、钾及磷离子水平下降,钠离子、氯离子及钙离子水平上升,其中ORS不限量组治疗前后钾离子水平[(4.27±0.85)mmol/L vs(4.02±0.27)mmol/L,P<0.05],磷离子水平[(1.68±0.26)mmol/L vs(1.42±0.27)mmol/L,P<0.05]比较差异有统计学意义,而ORS 500 mL/d组治疗前后仅磷离子变化差异有统计学意义[(1.67±0.25)mmol/L vs(1.44±0.31)mmol/L,P<0.05]。结论:ORSⅢ不限量口服可以改善NMS患儿血清钾及磷离子水平,为治疗症状明显NMS的有效方法。

Objective:To probe into the efficacy of different doses of oral rehydration salts(ORS)Ⅲin the treatment of children with neurally mediated syncope(NMS)and its effects on serum electrolytes.Methods:Clinical data of children with NMS diagnosed and treated in our hospital from Jan.2016 to Mar.2019 were retrospectively analyzed,including age,gender,serum sodium,serum potassium,serum chloride,serum phosphorus,serum calcium ion and head-up tilt table(HUTT)test at the time of initial diagnosis,and the treatment process and outcome were followed up.According to different doses of ORS during treatment,all patients were divided into the ORS 500 mL/d group and ORS unlimited group.SPSS 21.0 software was applied,andχ^(2)test was used for comparison between two groups,and paired t-test was used for intra-group comparison before and after treatment.Results:There was statistically significant difference in the effective rate between the ORS unlimited group and the ORS 500 mL/d group(90.9%vs 66.3%,χ^(2)=3.77,P<0.05).The difference of HUTT negative conversion rate between the ORS unlimited group and the ORS 500 mL/d group was statistically significant(72.2%vs 40.0%,χ^(2)=4.68,P<0.05).The treatment effect of ORS unlimited group was better,and the symptoms were improved significantly.After treatment,the levels of serum electrolyte sodium ion increased,the levels of potassium and phosphorus ion decreased,and the levels of chloride ion and calcium ion increased in different doses of ORS groups.Before and after treatment,the differences in levels of potassium ion((4.27±0.85)mmol/L vs(4.02±0.27)mmol/L,P<0.05)and levels of phosphorus ion((1.68±0.26)mmol/L vs(1.42±0.27)mmol/L,P<0.05)in the ORS unlimited group were statistically significant.The difference in the changes of phosphorus ion in the ORS 500 mL/d group before and after treatment was statistically significant((1.67±0.25)mmol/L vs(1.44±0.31)mmol/L,P<0.05).Conclusion:Unlimited oral administration of ORSⅢcan improve the serum levels of potassium and phosphorus ion in children with NMS,which is an effective way for the treatment of NMS with obvious symptoms.