A common cause of pediatric diarrheal disease: pediatric diarrhea or diarrheal disease, is a group of diseases characterized by increased number of stools and changes in stool properties caused by multiple pathogens and factors. Most infants and young children develop, and the incidence is high in children aged 6 months to 2 years. (1) Infectious factors: such as viral, bacterial, fungal, parasitic and other infections caused by enteritis, and dysentery, cholera and other statutory infectious diseases are singled out. Viral infections account for 80%, most notably rotavirus. (2) Non-infectious factors: such as bait diarrhea, symptomatic diarrhea, allergic diarrhea, other non-infectious diarrhea, etc. (3) susceptibility factors (endogenous factors): ① physiological characteristics: immature digestive system/heavy gastrointestinal tract burden; ② poor organism defense function: low gastric acid secretion, low serum immunoglobulin/SIgA, unestablished intestinal flora; ③ artificial feeding: lack of multiple active immune components in breast milk, susceptibility to contamination. (2) Clinical manifestations, staging and typing of pediatric diarrhea: (1) According to clinical manifestations: ① Light diarrhea: mainly gastrointestinal symptoms, the number of stools increases but generally does not exceed 10 times, and each time the amount is not much, yellow or yellow-green watery stool, fecal quality is not much, accompanied by a small amount of mucus. The child is still in good spirits, no systemic toxic symptoms and disorders of water, electrolytes, acid-base balance. ② Heavy diarrhea: heavy gastrointestinal symptoms, stool >10 times, decreased appetite, accompanied by vomiting; heavy systemic toxic symptoms, such as fever, irritability or depression, drowsiness, or even shock, coma; there are also water, electrolyte, acid-base balance disorders, such as dehydration, metabolic acidosis, hypokalemia, hypocalcemia, hypomagnesemia, etc. (b) According to the pathogenesis, it is divided into: ① secretory diarrhea: caused by enterotoxin-producing bacteria or viruses, with increased secretion from the small intestine, exceeding the absorption limit of the colon. (ii) Exudative diarrhea: caused by invasive bacteria that invade intestinal mucosal tissue, causing lesions such as congestion, edema, inflammatory cell infiltration, ulceration and exudation. (iii) osmotic diarrhea: lack of or insufficient secretion of disaccharidase, or due to excessive production of short-chain organic acids in the intestine, which increases the osmotic pressure of intestinal fluid in the intestine. ④Intestinal absorption disorder diarrhea. (⑤) Intestinal motility hyperactivity diarrhea. (c) According to the course of the disease: ① acute diarrhea: the duration of the disease <2 weeks. ② Extended diarrhea: duration of illness 2 weeks to 2 months. (③) chronic diarrhea: duration of disease > 2 months. Clinical features of rotavirus enteritis (the most common diarrhea): ① Most common in infants and children aged 6 months to 2 years. ②See more often in autumn and winter. ③ rapid onset, often accompanied by fever, upper sensation, vomiting and other symptoms. ④The stool is egg-flake soup-like or colorless watery, without fishy odor, with a small amount of mucus and minimal or no white blood cells on microscopic examination. Stools are frequent, voluminous, watery and yellow in color. ⑤ No obvious symptoms of toxicity, dehydration, acidosis and electrolyte disorders can occur in severe diarrhea. ⑥antibiotic treatment is ineffective, the duration of the disease is about 5-7 days. Fourth, the diagnosis and differential diagnosis of pediatric diarrhea: (1) stool without or less leukocytes: more consideration of viruses, non-invasive bacteria, parasites, external infections, improper feeding, etc.. (2) When the stool is full of white blood cells: mostly consider invasive bacterial infection. (3) Differential diagnosis: should be distinguished from physiological diarrhea, small intestine absorption disorder, bacterial dysentery, necrotizing enterocolitis, etc. V. Treatment of pediatric diarrhea: Treatment principles: prevention and correction of dehydration, adjustment and continuation of feeding, rational use of drugs, and strengthening of nursing. (A) general treatment: strengthen nursing care, pay attention to sterilization and isolation, diligent diaper changing, observation of dehydration and the speed of intravenous infusion, etc. (2) Diet therapy: continue to eat to prevent malnutrition. Continue breastfeeding and suspend complementary foods. For artificial feeders, give rice soup, diluted milk, curd feeding. For suspected lactase deficiency, suspend dairy feeding and switch to soy-based milk substitutes or fermented yogurt, or use lactose-free formula, etc. (c) pathogenic treatment: antibiotics are not advisable for viral enteritis, with dietary therapy and symptomatic treatment being the main focus. For invasive bacterial enteritis, choose effective antibiotic therapy. (D) fluid therapy: rehydration with oral rehydration salts (ORS rehydration salts) with water, the general physiological requirement is 60-80ml/kg per day. (E) treatment of prolonged and chronic diarrhea: identify the cause for appropriate treatment. Adjust the diet and strengthen nutrition. Apply microecological agents and supportive therapy. (f) Symptomatic treatment: ① Diarrhea: microecological regulators such as Bifidobacterium, Lactobacillus acidophilus, Streptococcus faecalis, Enterobacter cereus, aerobic bacillus preparations (Mamia, Mia A, Lotol), etc.; gastrointestinal mucosa protectors such as Similac; astringents such as ellagitin. Biliary acid diarrhea can be used with biliary amines. ②Distension: fat abdomen with the need to go to the hospital. ③ glycogenic diarrhea: because there can be varying degrees of secondary lactase deficiency, so you should stop eating lactose-rich foods and adopt a de-lactose diet, such as soy milk, yogurt, low-lactose or lactose-free formula, etc. 6. Nursing measures 1. Strict disinfection and isolation to prevent the spread of infection according to the isolation of intestinal infectious diseases, good bedside isolation, and careful hand washing before and after caring for the child to prevent cross-infection. 2, monitor temperature changes: high body temperature should be given to the child to drink more water, dry sweat, reduce the clothing eye, head pillow ice pack and other physical measures, good oral and skin care. 3. When you find that the child is weak, does not cry or cry is low, weakness of feeding, low muscle tone, unresponsiveness, nausea and vomiting, abdominal distension, go to the hospital in time. 4. Pay attention to the change of stool: observe and record the number, color, nature and amount of stool, and make dynamic comparison. 5, adjust the diet There is a digestive disorder in children with diarrhea. According to the condition of the child, arrange the diet reasonably to achieve the purpose of reducing the burden on the gastrointestinal tract and restoring the digestive function. Generally, in the stage of replenishing accumulated losses, fasting can be temporary for 4-6 hours (except for breastfeeding), and after the number of diarrhea decreases, liquid or semi-liquid such as porridge and noodles are given, and small amounts of multiple meals are given, and gradually transition to a normal diet as the condition stabilizes and gets better. Those with disaccharidase deficiency. Sucrose is inappropriate and dairy is suspended. 6. Use soft cloth diapers, change them regularly, wash the buttocks with warm water and dry them after each use, and apply 5% rubbing acid ointment or 40% zinc oxide oil to the local skin redness and massage for a moment to promote local blood circulation. Avoid using impermeable plastic cloth or rubber sheeting to prevent diaper dermatitis from occurring. 7.Guidance on reasonable feeding: promote the advantages of breastfeeding and avoid weaning in summer. Add complementary foods gradually and on time, avoid adding several complementary foods at the same time, prevent overfeeding, partial feeding and sudden changes in diet structure.