脊髓损伤后植物神经反射异常的临床特点及防治措施①.PDFVIP

中国康复理论与实践2018年10月第24卷第10期ChinJRehabilTheoryPract,Oct.,2018,Vol.24,No.10 - 1172 - DOI: 10.3969/j.issn. 1006-9771.2018.00.003 ·综述 · 脊髓损伤后植物神经反射异常的临床特点及防治措施① 1a,3 2 1b,3 1a,3 熊巍 ，苏跃 ，张军卫 ，王强 1. 中国康复研究中心北京博爱医院，a. 麻醉科；b. 脊柱脊髓外科，北京市100068；2. 首都医科大学附属北京世 纪坛医院麻醉科，北京市100038；3. 首都医科大学康复医学院，北京市100068 通讯作者：苏跃、王强。E-mail: suyue501@(苏跃);163.com(王强) 摘要 植物神经反射异常是一种多见于T 及以上脊髓损伤人群中的急性病症，慢性脊髓损伤患者中发病率较高， 6 常由损伤平面以下部位刺激诱发。突然的血压升高是主要的临床症状，未经处理的高血压可引起心脑血管意外 甚至死亡。植物神经功能紊乱的发病机制可能与脊上调节功能障碍、发生神经可塑性变化以及相关受体发生变 化有关。目前治疗及预防措施主要有去除诱因、体位调节及药物治疗。 关键词 脊髓损伤；植物神经反射异常；临床特点；机制；处理；综述 Clinical Characteristics and Treatment of Autonomic Dysreflexia after Spinal Cord Injury (review) 1a,3 2 1b,3 1a,3 XIONG Wei , SU Yue , ZHANG Jun-wei , WANG Qiang 1. a. Department of Anesthesiology; b. Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, China Re- habilitation Research Center, Beijing 100068, China; 2. Department of Anesthesiology, Beijing Shijitan Hospital, Capi- tal Medical University, Beijing 100038, China; 3. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China Correspondence to SU Yue, WANG Qiang. E- mail: suyue501@ (SU Yue); 163.com (WANG Qiang) Abstract Autonomic dysreflexia (AD) is an emergency commonly happened in patients with spinal cord injury (SCI) above T6 and especially in chronic SCI patients. AD is usually triggered by stimuli below the injury level. Sudden elevated blood pressure is the main clinical symptom and cardiovascular and/or cerebral complication even death if effective treatments are not provided. Mechanisms con