儿童腹泻病的规范化诊治-2017年直通车.pptx

儿童腹泻病的规范诊治;主要内容：;主要内容：;High incidence of diarrhea in children under five years old5岁以下儿童腹泻的发病率居高不下;Percentage of deaths among children under age 5 attributable to diarrhoea, 2015因腹泻死亡的儿童占5岁以下儿童所有死亡的百分比(9%);Diarrhoea is a leading killer of children, accounting for 9 per cent of all deaths among children under age 5 worldwide in 2015. ;Source: Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD);Improved sanitation facilities translates into fewer childhood diarrhoea-related deaths（卫生设施的改善减少儿童腹泻相关的死亡）;Source: WHO/UNICEF Joint Statement: Clinical management of acute diarrhoea, 2004;Coverage of oral rehydration treatment and continued feeding for diarrhoea is low across regions, particularly in the ones with highest mortality（口服补液治疗和继续喂养覆盖率仍旧低下,特别是在死亡率高的地区）;Little progress has been made since 2000 in expanding the use of ORS for treatment of childhood diarrhoea（自2000年以来在扩大使用口服补液盐治疗儿童腹泻中几乎没有取得任何进展）;Diarrhoea treatment with ORS is low overall and lagging in rural areas（口服补液盐治疗腹泻在农村地区整体滞后）;The richest children are more likely than the poorest children to receive ORS for diarrhoea（最富有的孩子更有可能比最穷的孩子接受腹泻的口服补液盐）;Countries with the highest levels of child death from diarrhoea have lowest levels of ORS coverage（口服补液盐使用覆盖率越低的国家其儿童死于腹泻的死亡率越高）; WHO/UNICEF（2013年4月12日）“预防及控制肺炎和腹泻的综合性全球行动计划”;Too few children with diarrhoea receive zinc supplementation in all regions（各地区太少的腹泻患儿得到补锌治疗）;主要内容：;腹泻病诊治方案和指南;儿童腹泻病史询问中应该注意的问题;腹泻相关症状与病原体之间的关系;腹泻儿童的体格检查;何种情况下易脱水;急性腹泻脱水评定相关问题;儿童临床脱水量表-CDS;急性腹泻患儿不同程度脱水临床表现;急性腹泻的实验室检查;粪便标记物检测：粪便WBC、OB、乳铁蛋白、钙卫蛋白;粪便培养：急性腹泻病人不推荐常规进行粪便的培养;血气分析电解质监测：;急???腹泻的辅助检查;急性腹泻的辅助检查-临床常见问题;何时就诊？;住院标准(Vb，D);出院标准;主要内容：;儿童腹泻病的治疗原则;首要原则：预防脱水和治疗脱水;口服补液盐（ORS）; “仅仅通过简单的口服补液的方法，就能够安全有效地治疗90%以上各种病因和各年龄患者的急性腹泻！”;;静脉补液的指征(Vb，D)(强推荐);ESPGHAN，2014;静脉补液-何种液体;高钠血症的治疗:;高钠血症的治疗:;急性腹泻时的营养问题？;急性腹泻时饮食原则;BRAT;急性腹泻的药物治疗-“锌”;急性腹泻的药物治疗-“益生菌”;急性腹泻的药物治疗-“益生菌”;急性腹泻的药物治疗-“益生菌”;急性腹泻的药物治疗-“吸附剂”;急性腹泻的药物治疗-“抗生素”;急性腹泻的药物治疗-“抗生素”;病原体;急性腹泻的药物治疗-“消旋卡多曲”;急性腹泻的药物治疗-“止吐止泻药”;主要内