小儿腹泻英文ppt课件.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Diagnosis and differential diagnosis 2.Many of leukocytes in stools Bacillary dysentery Necrotic enteritis * Treatment The principles Adjustment of the diet Prevention and improvement of the dehydration Proper drugs therapy Intensification of the nursing Prevention of the complications * Treatment 1.The therapy of the acute diarrhea (1) Dietotherapy (2) Improvement of the disturbance of the fluids, electrolyte and acid-base balance * Treatment 1) Oral fluid infusion Oral rehydration salts, ORS Component Sod. Chloridi 3.5g Sod. Bicarbonate 2.5g Pat Citrate 1.5g Glucose 20.0g Water 1000ml * Treatment ORS Tonicity 220 mmol/L (2/3 T ) Indication Mild dehydration: 50-80ml/kg Moderate Dehydration: 80-100ml/kg * Treatment ORS Contraindication Neonatal infant Vomiting Severe dehydration Shock Heart failure Renal failure High fever Abdominal distention Hypertonic dehydration * Treatment 2) Venous transfusion The first-day transfusion Total quantity of fluids Mild dehydration: 90-120ml/kg Moderate dehydration: 120-150ml/kg Severe dehydration: 150-180ml/kg * Treatment 2) Venous transfusion The quality of fluids Isotonic dehydration: 1/2 T Hypotonic dehydration: 2/3 T Hypertonic dehydration: 1/3 T * Treatment 2) Venous transfusion The transfusion rate Dilatation blood capacity phase 20ml/kg (in30-60min) Supplying the cumulative dose phase 8-10ml/kg·h (in8-12h) Supplying the maintenance dose phase 5ml/kg·h (in12-16h ) * Treatment 2) Venous transfusion Improvement of acidosis After transfusion, some patients with acidosis had corrected Severe acidosis 1.4% Sod.bicarbonate 5% Sod.bicarbonate (ml)=(-BE) ×0.5×WT (kg) Sod.bicarbonate(mmol)=(22—CO2cp)mmol x 0.6 x WT(kg) * Treatment 2) Venous transfusion Improvement of the hypokalium 10% KCL Solution