新补液盐配方减少儿童死亡率
联合国儿童基金会和世界卫生组织近日在日内瓦共同发布了一种生产口服补液盐(ORS)新配方的指南。这一新配方将有助于更好地帮助儿童抵御急性腹泻病，以推进联合国2015年之前将儿童死亡率减少2/3的千年发展目标。
世界卫生组织认为，目前，腹泻仍是造成儿童死亡的第二位主要原因，每年约有190万幼儿死于腹泻，主要原因是脱水。而当前公认的治疗儿童腹泻最为简单、有效和便宜的方法，便是在发生严重腹泻的情况下给予口服补液盐。口服补液盐溶液在小肠内被吸收，以迅速补充水和电解质的丢失。
最近改进的口服补液盐配方降低了葡萄糖和钠的含量，从原来的311 mOsm/l降低为现在的245 mOsm/l。新配方之所以选用较低浓度，目的是使溶液迅速吸收，减少静脉输液的必要性，让那些比较容易治疗的非霍乱急性腹泻的儿童无需住院治疗。新配方遵循了国际质量规范，联合国儿童基金会将主要向贫穷国家提供口服补液盐。
世界卫生组织和儿童基金会共同发布了生产新口服补液盐的指南，建议各国生产和使用新配方取代原配方，并将帮助国家当局制定新配方的生产准则和程序。在当地生产口服补液盐将是确保各国在控制腹泻病方面满足自身需求的关键一步。专家认为，口服补液治疗应与适当的喂养做法指导相结合。在急性腹泻发作期间，补充锌（每天20毫克锌，持续10至14天）和不间断的母乳喂养能够预防脱水并减少蛋白质和卡路里的消耗，能在减少儿童腹泻和营养不良方面发挥巨大作用。
Improved formula for oral rehydration salts to save children’s lives
Improved formula means better treatment for life-threatening diarrhoeal dehydration
PAHO
23 MARCH 2006 | NEW YORK/GENEVA -- The World Health Organization (WHO) and UNICEF today announced a new formula for the manufacture of Oral Rehydration Salts (ORS). The new formula will better combat acute diarrhoeal disease and advance the Millennium Development Goal of reducing child mortality by two-thirds before 2015.
Diarrhoea is currently the second leading cause of child deaths and kills 1.9 million young children every year, mostly from dehydration.
The latest improved ORS formula contains less glucose and sodium (245 mOsm/l compared with the previous 311 mOsm/l). The lower concentration of the new formula allows for quicker absorption of fluids, reducing the need for intravenous fluids and making it easier to treat children with acute non-cholera diarrhoea without hospitalization.
ORS use is the simplest, most effective and cheapest way to keep children alive during severe episodes of diarrhoea. The ORS solution is absorbed in the small intestine, thus replacing the water and electrolytes lost. WHO provides the only updated international quality specifications for this formula and UNICEF is a leading supplier of ORS to poor countries. WHO and UNICEF have jointly issued guidance for the production of the new ORS.
WHO and UNICEF recommend that countries manufacture and use the new ORS in place of the previous formula. WHO and UNICEF will help national authorities develop manufacturing guidelines and procedures for the new formula. Establishing the local production of ORS will be a key step to ensure countries can meet their own needs in controlling diarrhoeal disease.
According to UNICEF and WHO, oral rehydration therapy should be combined with guidance on appropriate feeding practices. Provision of zinc supplements (20 mg of zinc per day for 10 to 14 days) and continued breastfeeding during acute episodes of diarrhoea protect against dehydration and reduces protein and calorie consumption to have the greatest impact on reducing diarrhoea and malnutrition in children.
The revised monograph for the new ORS formula will be published in the fourth edition of The International Pharmacopoeia. It is also available on the WHO website.
Additional information on diarrhoea can be found on UNICEF's Facts for Life website and on the WHO Child and Adolescent Health web site
Detailed recommendations concerning the provision and production of ORS are provided in a revised joint WHO/UNICEF publication, 'Oral Rehydration Salts: Production of the New ORS'.
