论文部分内容阅读
氢氧化铝治疗婴幼儿秋冬腹泻国内外尚未见报道,国外有用氢氧化铝治疗慢性迁延性腹泻与胆汁酸吸收不良性腹泻成功的报告。我科用氢氧化铝凝胶治疗婴幼儿秋冬腹泻27例,与对照组30例比较疗效较好。本组病例均有腹泻,为蛋花汤样便或水样便。发热者39例,占68%;伴呕吐者35例,有脱水者46例,占81%;其中轻度脱水38例,中度脱水8例。本组77%病例白细胞总数在1万以下,大便常规41例为阴性,仅少数病例有少许白细胞(0—3个/HP)及脂肪球(+～+++),大便培养除1例培养出副大肠杆菌外均为阴性,本组病例25例有尿改变,为蛋白尿,或有白细胞、红细胞及上皮细胞,与病毒感染有关。两组病例年龄、病情、发病天数及一般治疗措施无明显差异。氢氧化铝凝胶组2天内止泻21例,占78%,平均止泻天数1.96±0.173(天),对照组2天内止泻12例,占40%,平均止泻天数2.7±0.215(天),经统计学处理差异显著(t=2.453,P<0.05)。秋冬婴幼儿腹泻以病毒感染为主,1982年广东省小儿腹泻协作组证实轮状病毒为广州地区秋冬腹泻主要病原。国外文献认为急性感染性腹泻可能有胆什酸分泌增加及吸收障碍。氢氧化铝是一种制酸剂,能对抗胆汁酸,铝为3价阳离子,可能有加固细胞膜的作用,能抑制钙离子移动,从而抑制肠道液体的分泌,起到止泻效果,另外铝盐类能吸附肠毒素及代谢产物。我科用氢氧化铝凝胶治疗婴幼儿秋冬腹泻能缩短病程,除3例发生便秘外,余未发现副作用,便秘经减量或停药后症状即可消失。
Aluminum hydroxide treatment of infantile autumn and winter diarrhea at home and abroad have not been reported, the foreign use of aluminum hydroxide in the treatment of chronic persistent diarrhea and bile acid malabsorption of diarrhea success report. 27 cases of autumn and winter diarrhea treated with aluminum hydroxide gel in our department were compared with 30 cases in the control group and the curative effect was better. This group of patients have diarrhea, egg-like soup or watery stools. 39 cases of fever, accounting for 68%; 35 cases with vomiting, 46 cases of dehydration, accounting for 81%; of which 38 cases of mild dehydration, moderate dehydration in 8 cases. The total number of leukocytes in 77% of cases in this group was less than 10,000 and the stool routine was negative in 41 cases. Only a few cases had a few white blood cells (0-3 / HP) and fat globules (+ ~ +++) E. coli were negative outside the group, 25 cases of this group of patients with urinary changes, proteinuria, or white blood cells, red blood cells and epithelial cells, and the virus infection. Two groups of patients age, illness, onset days and general treatment no significant difference. In the aluminum hydroxide gel group, there were 21 cases of diarrhea in 21 days, accounting for 78% of the total, and the average number of days of antidiarrheal was 1.96 ± 0.173 days. In the control group, there were 12 cases of diarrhea in 12 days (40%), and the mean days of antidiarrheal (2.7 ± 0.215 days ), The difference was statistically significant (t = 2.453, P <0.05). Fall and winter infants and young children with viral infection, diarrhea in Guangdong Province in collaboration group confirmed that rotavirus in Guangzhou in autumn and winter diarrhea main pathogen. Foreign literature that acute infectious diarrhea may have increased acid secretion and absorption disorders. Aluminum hydroxide is an antacid which can counteract bile acids. Aluminum is a trivalent cation that may have the effect of reinforcing the cell membrane, inhibiting the movement of calcium ions, inhibiting the secretion of intestinal fluids, and acting as an anti-diarrhea effect. In addition, aluminum Salts can absorb enterotoxins and metabolites. Our department with aluminum hydroxide gel treatment of infantile autumn and winter diarrhea can shorten the course of disease, except for 3 cases of constipation, I found no side effects, constipation by reduction or withdrawal symptoms can disappear.