MILD DEHYDRATION (6% OR LESS)Mild d

<br>轻度脱水（6％或更少）在家中可以处理急性胃肠炎的轻度脱水，口服补液疗法为主要治疗方法。24荟萃分析发现口服补液和静脉补液在住院或急诊就诊方面无显着差异。 [25]，接受ORS治疗的25名儿童中只有1名最终需要静脉输液。26<br><br>ORS的特定电解质成分对于轻度脱水并不重要。例如，一项针对六个月以上儿童的研究表明，与正式的ORS相比，半强度苹果汁加首选液体（常规果汁，牛奶）减少了最终静脉补液的需要27，最可能的原因是儿童更容易喝比ORS更可取的液体。每次大便后，世界卫生组织（WHO）建议给两岁以下的孩子服用50至100毫升的液体，两岁至10岁的孩子服用100至200毫升的液体。年龄较大的孩子可能需要的水分过多。儿童每小时每公斤体重最多可能消耗20毫升。12<br><br>中度严重脱水（超过6％）<br>中度脱水的治疗包括ORS加药物，以减少呕吐和提高ORS的耐受性。对于中度脱水的儿童，口服补液与静脉补液在预防住院和回访方面同样有效。28ORS <br><br>。在最近的更改中，WHO现在建议降低渗透压的ORS，每升钠中含有75 mEq的钠和每升溶解于1 L水中的葡萄糖每升75mmol。12以前，标准的WHO WHO ORS含有每升钠90 mEq。如果在六个月以下的婴儿中使用这种较老的溶液，则应另外添加100至200 mL的清水。或者，可以使用在1 L水中的½茶匙盐和6茶匙糖的自制溶液。12表4包括WHO给予儿童ORS的指南12。

轻度脱水（6% 或更少）<br>急性肠胃炎的轻度脱水可以在家里进行治疗，口服补液疗法是治疗的支柱。<br><br>ORS 的特定电解质成分对轻度脱水并不重要。例如，一项对6个月以上儿童的研究表明，半强度的苹果汁和首选液体（普通果汁、牛奶）比正式的 ORS 减少了最终静脉补液需求，27 很可能是因为儿童比 ORS 更容易饮用首选液体。每次松粪后，世界卫生组织（WHO）建议给两岁以下儿童50至100 mL的液体和2至10岁的儿童100至200 mL的液体;年龄较大的孩子可能拥有尽可能多的液体。儿童每小时每公斤体重可消耗20毫克。<br><br>中度至重度脱水（超过6%）<br>中度脱水的治疗包括 ORS 加药物，如果需要减少呕吐和提高 ORS 的耐受性。对于中度脱水儿童，口服补液与静脉补液一样有效，可预防住院和回访。<br><br>奥尔斯在最近的一次变化中，世卫组织现在建议减少的渗透性 ORS，它含有每升钠75 mEq，每L含有75 mmol，溶解在1 L水中。如果在6个月以下的婴儿中使用这种较旧的溶液，应额外添加100至200 mL的清洁水。或者，可以使用自制的1/2茶匙盐和6茶匙糖溶液在1 L的水。

MILD DEHYDRATION (6% OR LESS)Mild dehydration from acute gastroenteritis can be managed at home, with oral rehydration therapy as the mainstay of treatment.24 A meta-analysis found no significant difference in hospitalizations or return emergency department visits between oral and intravenous rehydration,25 and only one out of 25 children treated with an ORS will eventually require intravenous fluids.26The specific electrolyte composition of the ORS is not important for mild dehydration. For example, one study of children older than six months showed that half-strength apple juice followed by preferred fluids (regular juices, milk) reduced the need for eventual intravenous rehydration compared with a formal ORS,27 most likely because children were more apt to drink the preferred fluids than the ORS. After each loose stool, the World Health Organization (WHO) recommends giving children younger than two years 50 to 100 mL of fluid and children two to 10 years of age 100 to 200 mL of fluid; older children may have as much fluid as they want. Children may consume up to 20 mL per kg of body weight per hour.12MODERATE TO SEVERE DEHYDRATION (MORE THAN 6%)Treatment of moderate dehydration includes an ORS plus medication if needed to decrease vomiting and improve tolerance of the ORS. For children with moderate dehydration, oral rehydration is as effective as intravenous rehydration in preventing hospitalization and return visits.28ORS. In a recent change, WHO now recommends its reduced osmolarity ORS, which contains 75 mEq per L of sodium and 75 mmol per L of glucose dissolved in 1 L of water.12 Previously, the standard WHO ORS contained 90 mEq per L of sodium. If using this older solution in infants younger than six months, an additional 100 to 200 mL of clean water should be added. Alternatively, a homemade solution of ½ teaspoon salt and 6 teaspoons sugar in 1 L of water may be used.12 Table 4 includes WHO guidelines for administering ORS in children.12<br>