使用磷酸钠灌肠会导致电解质紊乱吗?

Songül Tomar Güneysu, O. Güleryüz, N. Karakaş, Özlem Çolak
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摘要

便秘是儿童时期最常见的症状之一。磷酸钠灌肠通常是治疗便秘和清洁肠道的首选方法。我们介绍了一例 5 岁男孩的病例,他因便秘、腹痛、腹胀和呕吐等症状到儿科急诊就诊,便秘已有两年左右,营养不良,在入院前的 12 小时内接受过两次全剂量 CT 灌肠®。到达儿科急诊室后,医生给患者进行了小儿舰队灌肠,因为根据放射线证据,他的粪便密度很高。由于实验室评估显示患者存在严重的高磷酸盐血症和低钙血症,因此考虑为磷酸钠灌肠中毒。开始快速静脉补液,并静脉输注 1 mL/kg 葡萄糖酸钙。在随访的第 14 个小时,电解质恢复到正常范围,无需进行额外治疗。本病例旨在强调,由于磷酸钠灌肠剂被广泛用于治疗慢性便秘,即使健康患者使用治疗剂量的磷酸钠灌肠剂,也可能导致磷酸盐中毒。
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Does sodium phosphate enema use cause electrolyte disorder?
Constipation is one of the most common symptoms in childhood. Sodium-phosphate enemas are frequently preferred for the treatment of constipation and bowel cleansing. We present a case of a 5-year-old boy who presented to the Pediatric Emergency Department with complaints of constipation, abdominal pain, abdominal distension and vomiting; had been constipated for about two years and had poor nutrition, and received a full dose of CT enema® twice in the last 12 hours before admission to the hospital. Upon arrival at the Pediatric Emergency Department, the patient was given a pediatric fleet enema because he had dense stools according to radiographic evidence. Poisoning due to Sodium-phosphate enema was considered due to severe hyperphosphatemia and hypocalcemia in the laboratory evaluation. Rapid intravenous hydration and 1 mL/kg calcium gluconate intravenous infusion were started. Electrolytes returned to the normal range at the 14th hour of follow-up without the need for additional treatment. This case is presented to emphasize that due to the widespread use of sodium-phosphate enemas in the treatment of chronic constipation, these enemas can cause phosphate poisoning even when used in healthy patients at therapeutic doses.
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