Fontaine, Gore, and Pierce (1999) address another important aspect of acute diarrhea, cholera versus noncholera. Their systematic review includes a wide range of resources and the most up-to-date information. This study excluded female children due to difficulty in measuring precise stool output. All of the clinical trials were hospital-based.
A weakness of the systematic review by Fontaine, Gore, and Pierce is that none of the studies indicated the timing of the randomization, so it is possible that some subjects were randomized after the onset of IV hydration, potentially skewing the first 24-hour stool measurements. Also, all of the children studied with cholera diarrhea were considered severely dehydrated. In addition, only 15 of the 22 clinical trials were double-blinded studies, which may lead to potential evaluator bias of the remaining 7 trials. The focus of the results was limited to first 24 hours of treatment, leaving unanswered questions regarding duration and cessation of diarrhea.
Implications for Practice
The studies reviewed in this report clearly confirm the safety and efficacy of ORT in infants and children with uncomplicated, acute diarrhea in developed countries. The WHO has made ORT a staple in the reduction of morbidity and mortality in developing countries. In 1996, the American Academy of Pediatrics (AAP) established guidelines for the utilization of physiologically appropriate ORT for infants and children that were based on the 1992U.S. Centers for Disease Control and Prevention guidelines for the appropriate fluid, electrolyte, and nutrition therapy of diarrhea (Hugger, Harkless, Rentschler, 1999).
- 1 0 年前最佳解答
Fontaine 、戈爾, 和皮爾斯(1999) 地址其它深刻腹瀉,
霍亂的重要方面對noncholera 。他們系統的回顧包括大範圍資源和最新資訊。這項研究排除了女性孩子由於困難在測量精確凳子產品。所有臨床試驗醫院根據了。系統的回顧的弱點由Fontaine 、戈爾, 和皮爾斯是, 無研究表明了randomization 的時間, 因此它是可能的一些主題被隨機化了在IV 水合作用以後起始, 潛在地歪曲第一24 小時凳子測量。並且, 所有孩子被學習以霍亂腹瀉被認為嚴厲地被脫水。另外, 只15 22 次臨床試驗是雙重被矇蔽的研究, 也許導致殘餘的7 次試驗的潛在的評估者偏心。結果的焦點對第一個24 小時治療被限制了, 留下未回答的問題關於腹瀉的期間和停止。涵義為實踐研究被回顧在這個報告清楚地證實ORT 安全和效力在嬰幼兒以不複雜, 深刻腹瀉在發達國家。世界衛生組織做了ORT 一根釘書針在病態和必死的減少對發展中國家。1996 年, 小兒科的美國學院(AAP) 建立了指南為生理地適當的ORT 的運用為根據1992.U.S 的嬰幼兒。疾病控制中心和預防指南為適當的流體、電解質, 和營養療法腹瀉(Hugger 、Harkless, Rentschler 1999)
2006-04-05 13:18:12 補充：
你的發問已全部看過並回答希望我都是最佳回答喔以下是我的信箱helenlee15@yahoo.com.tw如果還有需要翻譯的寄給我知識家的網址我很樂意幫忙^^ 合作愉快參考資料： 希望繼續合作喔