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幼童如果腹瀉,不要急著立即就醫服止瀉藥!

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幼童如果腹瀉,不要急著立即就醫服止瀉藥!

三總日前分別接獲3例1至3歲幼童,因腹瀉不當服用止瀉藥,結果腸胃道中有害物質及毒素無法排出,導致腸穿孔合併腹膜炎的病例。醫師表示,幼童腹瀉如果不是狂拉,建議初期先在家中予以禁食及補充電解質的支持性療法,如果病況仍未改善再就醫。如果就醫服用止瀉藥後,腹瀉情況有改善,但卻出現腹脹及腹痛的情形,有可能腸穿孔前期病兆,一定要回診或是到較大的醫院就醫。

三總小兒外科主治醫師陳克琦表示,這3名幼童都有發燒、腹瀉疑似腸胃炎的症狀,且都有到住家附近診所就醫,並吃了醫師開立的止瀉藥,結果腹瀉症狀雖然獲得改善,卻引發腸穿孔合併腹膜炎更嚴重的問題,經緊急手術修補腸破洞、並給予抗生素治療後,病患於住院1週後出院。

陳克琦指出,由於腹瀉腸道蠕動會加快,有利於有害腸胃物質及毒素排出,因此一般腹瀉透過支持性療法後即可獲得改善,不過,臨床觀察發現,不少父母在孩子出現腹瀉症狀後,立即就給止瀉藥,結果反而使得腸胃道中有害物質及毒素無法排出。

尤其有些醫師所開立的藥物除了止瀉藥之外,還有抗生素,反而讓腸道中可以抑制壞菌的好菌被殺死,如果抗生素無法對症下藥,腸道中的壞菌繼續繁殖,結果即會引發更嚴重的腸穿孔,甚至合併腹膜炎。

陳克琦表示,腸穿孔一般好發於5歲以下,初期症狀為發燒腹瀉,大部分由沙門氏菌及綠膿桿菌所引起,若延誤治療可能會引發敗血症造成死亡。如果腹瀉在服用止瀉藥後,仍有腹脹及腹痛的情形,一定要再回診,即時處置可以減輕病症,避免腸穿孔的發生。
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