正常器官灌注和血流动力学稳定性指标恢复:有高质量的证据表明,对于血容量不足的儿童,等渗盐水是静脉液体复苏的首选液体。一项比较各种胶体液和晶体液的大型、随机、对照试验研究显示,在恢复器官灌注和血流动力学稳定性指标方面,晶体液与胶体液效果等同,但胶体液更贵。[29]Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2013;(2):CD000567.http://www.ncbi.nlm.nih.gov/pubmed/23450531?tool=bestpractice.com[30]Ngo NT, Cao XT, Kneen R, et al. Acute management of dengue shock syndrome: randomized double-blind comparison of 4 intravenous fluid regimens in the first hour. Clin Infect Dis. 2001;32:204-213.http://www.ncbi.nlm.nih.gov/pubmed/11170909?tool=bestpractice.com[31]Wills BA, Nguyen MD, Ha TL, et al. Comparison of three fluid solutions for resuscitation in dengue shock syndrome. N Engl J Med. 2005;353:877-889.http://www.ncbi.nlm.nih.gov/pubmed/16135832?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
正常器官灌注和血流动力学稳定性指标恢复:有高质量的证据表明,对于血容量不足的儿童,等渗盐水是静脉液体复苏的首选液体。一项比较各种胶体液和晶体液的大型、随机、对照试验研究显示,在恢复器官灌注和血流动力学稳定性指标方面,晶体液与胶体液效果等同,但胶体液更贵。[29]Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2013;(2):CD000567.http://www.ncbi.nlm.nih.gov/pubmed/23450531?tool=bestpractice.com[30]Ngo NT, Cao XT, Kneen R, et al. Acute management of dengue shock syndrome: randomized double-blind comparison of 4 intravenous fluid regimens in the first hour. Clin Infect Dis. 2001;32:204-213.http://www.ncbi.nlm.nih.gov/pubmed/11170909?tool=bestpractice.com[31]Wills BA, Nguyen MD, Ha TL, et al. Comparison of three fluid solutions for resuscitation in dengue shock syndrome. N Engl J Med. 2005;353:877-889.http://www.ncbi.nlm.nih.gov/pubmed/16135832?tool=bestpractice.com
成功处理血容量不足:有中等质量证据显示,在处理血容量不足方面,口服补液疗法取得了全球范围内的成功。[21]Spandorfer PR, Alessandrini EA, Joffe MD, et al. Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics. 2005;115:295-301.http://www.ncbi.nlm.nih.gov/pubmed/15687435?tool=bestpractice.com[22]Hartling L, Bellemare S, Wiebe N, et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst Rev. 2006;(3):CD004390.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004390.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/16856044?tool=bestpractice.com[23]Atherly-John YC, Cunningham SJ, Crain EF. A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Arch Pediatr Adolesc Med. 2002;156:1240-1243.http://archpedi.ama-assn.org/cgi/content/full/156/12/1240http://www.ncbi.nlm.nih.gov/pubmed/12444837?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
成功处理血容量不足:有中等质量证据显示,在处理血容量不足方面,口服补液疗法取得了全球范围内的成功。[21]Spandorfer PR, Alessandrini EA, Joffe MD, et al. Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics. 2005;115:295-301.http://www.ncbi.nlm.nih.gov/pubmed/15687435?tool=bestpractice.com[22]Hartling L, Bellemare S, Wiebe N, et al. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst Rev. 2006;(3):CD004390.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004390.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/16856044?tool=bestpractice.com[23]Atherly-John YC, Cunningham SJ, Crain EF. A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Arch Pediatr Adolesc Med. 2002;156:1240-1243.http://archpedi.ama-assn.org/cgi/content/full/156/12/1240http://www.ncbi.nlm.nih.gov/pubmed/12444837?tool=bestpractice.com
改善脱水指标和缩短住院时间:有中等质量证据表明,对于轻度至中度血容量不足儿童,与进行静脉内补液相比,经鼻胃管途径进行补液在缩短住院时长和脱水指标方面的效果相当,并且可以避免静脉治疗的并发症。[28]Nager AL, Wang VJ. Comparison of nasogastric and intravenous methods of rehydration in pediatric patients with acute dehydration. Pediatrics. 2002;109:566-572.http://www.ncbi.nlm.nih.gov/pubmed/11927697?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
改善脱水指标和缩短住院时间:有中等质量证据表明,对于轻度至中度血容量不足儿童,与进行静脉内补液相比,经鼻胃管途径进行补液在缩短住院时长和脱水指标方面的效果相当,并且可以避免静脉治疗的并发症。[28]Nager AL, Wang VJ. Comparison of nasogastric and intravenous methods of rehydration in pediatric patients with acute dehydration. Pediatrics. 2002;109:566-572.http://www.ncbi.nlm.nih.gov/pubmed/11927697?tool=bestpractice.com