Acute diarrhea: a practical review.
Acute diarrhea: a practical review.
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DOI：
10.1016/s0002-9343(99)00128-x
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发表时间：
1999-06
期刊：
影响因子：
--
通讯作者：
Giannella RA
中科院分区：
文献类型：
--
作者：
Aranda-Michel J;Giannella RA
本文综述了一种实用、简单、合理的方法来诊断和治疗急性感染性腹泻，这是临床实践中最常见的诊断之一。还讨论了免疫功能低下宿主的腹泻、旅行者腹泻和住院患者的腹泻。大多数急性腹泻发作是自限性的，只有当结果会影响治疗和预后时，才应进行调查。在充分的病史和体格检查后，临床医生应该能够对急性腹泻疾病进行分类，评估严重程度，并决定是否需要调查。大多数患者不需要特殊治疗。治疗应主要针对防止脱水。各种家庭疗法通常足以治疗轻度自限性腹泻。然而，在大容量脱水腹泻中，应使用口服补液，因为它们的配方是为了刺激钠和水的吸收。止泻剂可用于减少排便次数和减少液体流失的程度。最有用的药剂是阿片衍生物和次水杨酸铋。大多数急性腹泻病患者不需要抗生素治疗。并提出了使用指南。
This review provides a practical, simple, and logical approach to the diagnosis and management of patients with acute infectious diarrhea, one of the most common diagnoses in clinical practice. Diarrhea in the immunocompromised host, traveler’s diarrhea, and diarrhea in the hospitalized patient are also discussed. Most episodes of acute diarrhea are self-limited, and investigations should be performed only if the results will influence management and outcome. After an adequate history and physical examination, the clinician should be able to classify the acute diarrheal illness, assess the severity, and determine whether investigations are needed. Most patients do not require specific therapy. Therapy should mainly be directed at preventing dehydration. Various home remedies frequently suffice in mild, self-limited diarrhea. However, in large-volume, dehydrating diarrhea, oral rehydration solutions should be used, as they are formulated to stimulate sodium and water absorption. Antidiarrheal agents can be useful in reducing the number of bowel movements and diminishing the magnitude of fluid loss. The most useful agents are opiate derivatives and bismuth subsalicylate. Antibiotic therapy is not required in most patients with acute diarrheal disorders. Guidelines for their use are presented.
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