Dyspepsia Easy - a disease that develops mainly in children in the first year of life.The reasons: improper child feeding (plenty of frequent feeding, overfeeding, underfeeding, the food does not meet the age, a quick switch to bottle-feeding, overload fat, carbohydrates or protein), violation of the regime of care (overheating, weaning in the hot season),intestinal infection (increased activity of conditionally pathogenic flora), as well as various other diseases (pneumonia, otitis media, acute respiratory disease), against which develops so-called parenteral dyspepsia.Perhaps a combination of these factors.Most dyspepsia observed in immunocompromised children suffering from exudative diathesis, rickets, malnutrition.
The disease - a decrease of enzymatic activity of the gastrointestinal tract, increased fermentation processes to produce large amounts of gas, reduced intestinal absorption.Home
most acute;It appears regurgitation, sometimes vomiting, decreased appetite.Chair 8-10 times a day, liquid
necessary to find out the root cause of dyspepsia, eliminate overfeeding or not age-appropriate foods to eliminate the mixture rich in fat and sugar.During the first 6-9 hours passed feeding one or two, given the child at this time abundantly drink an isotonic solution of sodium chloride and tea based liquid of 150 ml per 1 kg of body weight per day.When parenteral dyspepsia with little dyspeptic phenomena can not make a break in feeding, ie,. Continue to breastfeed, while bottle-fed formula milk substitute sour (yogurt, buttermilk).
After a pause in feeding the baby is applied to the chest only 5 minutes or expressed milk yield, while formula-fed - acidic mixture, but half amount.Then, in the next 2-3 days the amount of food gradually adjusted to the age norm (under the control of the chair).The missing amount of food to compensate fluid.Assign vitamins, pepsin with hydrochloric acid or natural gastric juice, pancreatin.
Rp .: Ac.hydrochlorici diluti 1,0 Pepsini 2,0 Aq.destill.100,0
M. D. S. For 1 teaspoon 3 times a day before meals
Rp .: Pancreatini 0,15-0,2 Calcii carbonati 0,25 M. f.pulv.D. t.d.N. 10 S.
On 1 powder 3 times a day after meals
flatulence, abdominal pain showing on his stomach heat, hot compress, dill water, holes, chamomile 1 teaspoon several times a day, the vapor tube.When parenteral dyspepsia, in addition to diet, you need to treatment of the underlying disease;prescribe antibiotics, sulfa drugs.With proper, timely treatment course and outcome of disease favorable.
Toxic syndrome may develop on the background of various diseases (acute gastrointestinal, pneumonia, influenza, acute respiratory infections, staphylococcal infections), especially in young children.Relative frequency of toxic forms of diseases in this age group due to the extreme vulnerability of the central nervous system, metabolic lability, increased vascular permeability.The younger the age of the child, the greater the possibility of toxicity.Clinically, there are two options toxicity: toxemia with a primary violation of water-salt metabolism (exsicosis) and hemodynamic and neurotoxicosis with predominant reaction on the part of the central nervous system and the autonomic nervous system.
toxicosis with exsicosis more common in infants, especially the first few months of life, weak, suffering from malnutrition, who reduced the enzymatic activity of the digestive system and the bactericidal activity of digestive juices.In these circumstances, under the influence of various unfavorable factors of external and internal environment of enhanced growth and pathogenicity of intestinal microflora and its distribution.Bacterial toxins, microbes and their metabolic products together with other pathological components of the intestinal contents easily prominaetsya through the intestinal and hepatic barriers into the bloodstream and have a toxic effect on the central nervous system and its regulatory mechanisms, and the distorted function and other organs and systems, greatly disturbed metabolism, reduced immunity.
disease often acute onset, rapid, the child is excited, restless, but rapidly develop lethargy, weakness.There are frequent vomiting and retching without food in the vomit food residues, mucus, bile impurity.Number of vomit exceeds the volume of the resulting baby food and water.Chair frequent - up to 8-20 times a day, copious, watery, sometimes bristling, poor stool, with mucus.In connection with the violation of water absorption and rapid loss of fluid develops dehydration, body weight decreases rapidly (in 1 kg or more for 2-3 days).
Dehydration sharpened features, there is dryness of the sclera and mucous membranes, sink and a large fontanelle eyes, lips vivid, dry skin become earthy-gray hue, the skin, taken in the fold, bad crushes, tissue turgor reduced.Can develop sclerema, mainly in the lower limbs (seal subcutaneous fat reaches the consistency of cartilage).It appears toxic breathing - breathing noisy "hunted animal", disrupted the activities of the cardiovascular system (rapid pulse, low, dull tones, reduced blood pressure, cold extremities) and kidneys.Consciousness is occasionally obscured, look into the distance, can develop automatic movement of fingers, then convulsions - coma.
Blood thickens, while noting a false increase in the number of red blood cells and hemoglobin.Urine separates little, it detected a protein, erythrocytes, leukocytes, cylinders, in extreme cases be anuria.At the beginning of the disease almost always temperature rises to 39-40 ° C and then rapidly decreases.Clinical manifestations
with exsicosis toxicity may vary somewhat depending on the preferential loss of water or salts that must be considered when assigning treatment.
soledefitsitnom exsicosis When dominates the loss of electrolytes, there is a sharp shift in the acid-base balance towards acidosis, decreased potassium, sodium, chloride, calcium sometimes.The lead in the clinic is a potassium deficiency - a sharp lethargy, drowsiness, lethargy, weakness, confusion, muscle hypotonia, decreased reflexes.Due to the sharp decrease in muscle tone disturbed breathing, expanding the boundaries of the heart and noted the special deafness of tones of heart, reduced blood pressure, develops paresis bowel, accompanied by flatulence.
«Pure" water-scarce exsicosis rare, he held a sharp excitation child, restlessness, fever, sleep disturbance, tendency to muscle hypertonicity, tension neck, seizures, increased thirst;when it sharply reduced flows, salivation and urination.
Most observed isotonic e to a and s on, in which loss of fluid and electrolytes and a uniform clinical picture depends on the extent and depth of metabolic disorders.
toxicosis usually develops within 2-3 days, with proper treatment takes place in 3-4 days, but complete recovery lasts 2-3 weeks.During this period, a secondary infection can join under adverse conditions (stomatitis, otitis media, Piura, pneumonia and other intercurrent diseases).Always after suffering from toxemia progresses child malnutrition and vitamin deficiencies.If the child is not provided timely assistance, death is possible.
comprehensive treatment, including anti-toxicity and causes, its cause, the elimination of dehydration and acidosis, infection control, recovery of enzyme activity and normal digestive processes and symptomatic therapy.Detoxification
achieve dehydration and elimination of immediate intravenous or plasma substitutes the rate of 10-20 ml / kg body weight by administering aqueous tea starvation diet for 12-24 hours depending on the severity of the condition.During this period, fluid is introduced at the rate of 100-150 ml / kg body weight, which must be a child of a given age.Fluid is introduced through the mouth, in / under the skin, enemas.Drink give approximately 1/3 of the total amount of fluid injected per day - water, tea with 3% sugar solution or Ringer's half with a 5% glucose solution.Drinking gives dosed 1 teaspoonful every 5-10 minutes;If vomiting persists, the fluid is instilled into the mouth pipette.B / in the liquid drop administered slowly over several hours, first at 20 drops, followed by 10-15 drops per minute.The composition of fluid injected is determined by the nature of exsicosis.If the clinical nature of toxicity is unclear, it is desirable to use a mixture of equal parts of Ringer's solution and 5% glucose solution.When the ratio of water-scarce exsicosis Ringer's solution glucose and 1: 3, soledefitsitnom - 2: 1.Keep in mind that excessive administration of a single liquid of any kind (only glucose or only Ringer's solution) can lead to serious complications.When potassium deficiency should be administered 0.3% potassium chloride solution as drinking 30-50 ml / kg body weight for intravenous administration, 7.5% solution of potassium chloride, which is administered in admixture with Ringer's solution or 5% glucose solution.After
hungry-water discharge is recommended that breast-feeding expressed breast milk by 10 ml every 2 hours, t. E. 10 times per day.If there is no breast milk, administered in the same amount of B-rice, yogurt-B or a mixture of number 2.Each day at the feeding was added 10 ml of milk, gradually bringing the volume up to the age norm.Starting with a 5-6 day gently applied to the breasts for 3-5 minutes and then finish feeding expressed milk.With rapidly declining toxicosis can slightly increase the pace of quantitative gain power, but this should be done cautiously.Resumption of flatulence, regurgitation, vomiting, restlessness indicates an overload in power, with which the child is unable to cope, and he may again worsen toxemia.
to fight infection prescribe antibiotics acting on intestinal group (chloramphenicol, tetracycline in doses of age) in conjunction with ftalazolom and other sulfanilamidnymi drugs (indication).Necessarily administered early enzymes: pepsin with hydrochloric acid, the natural gastric juice, pancreatin.Apply symptomatic agents - heart medications, kordiamin, caffeine, vitamin complex.From the 2nd week expanding stimulating therapy: introducing gamma globulin, blood transfusions, plasma.
necessary to ensure that a child is very good care, careful monitoring of the condition of the skin and mucous membranes, prolonged exposure to the outdoors, peaceful sleep.
leading in its clinical picture are the symptoms of the nervous system, as a result of intoxication develop cerebral edema, may be a brain hemorrhage and necrosis.Exsicosis missing, but quickly consciousness is disturbed, there are cramps, dysfunction of the cardiovascular system and kidneys.A child can fall into a coma.
necessary to improve diuresis, reduce intracranial pressure, spending antipyretic therapy.For dehydration / injected 20-40% glucose solution, transfusions plasma prescribed hydrochlorothiazide, furosemide (Lasix) in doses of age.Showing Corticosteroids - prednisone 1 mg / kg of body weight per day short course.Antibiotic therapy is carried out depending on the nature of the underlying disease that caused neurotoxicosis.For special reasons, in severe meningeal syndrome, diagnostic and therapeutic purposes requires a lumbar puncture.