脑损伤后发作性交感过度兴奋 .pptVIP

脑损伤后发作性交感过度兴奋 Perkes I, Baguley IJ, Nott MT, Menon DK、 A review 1、 of paroxysmalsympathetic hyperactivity after acquired brain injury、 Ann Neurol2010; 68: 126–135、 tachycardia ( 120beats/min), tachypnea ( 30/min), systolic hypertension ( 160mmHg), hyper/hypothermia, excessive sweating, decerebration/decortication, increased muscle tone, horripilation鸡皮疙瘩 and/or flushing皮肤发红 is collectively referred to as “dysautonomia” or “paroxysmal sympathetic hyperactivity” syndrome 典型的体温血压图 过山车 发病率高低不一 9、3–33%、 Kishner S, Augustin J, Strum S、 Post head injury autonomic plications、 Last updated 4 October 2006 October 4、 Accessed 18 June 2007、 Fearnside MR, Cook RJ, McDougall P, McNeil RJ、 The westmead head injury project oute in severe head injury、 A parative analysis of pre-hospital, clinical and CT variables、 British Journal of Neurosurgery 1993;7:267–279、 In the first post-injury week in ICU、 Of the whole sample, 33% developed heart rates 120/min and respiratory rates 30/min and 25% had blood pressure 160mmHg and temperature 39C at some time in the first week、 Lemke DM、 Sympathetic storming after severe traumatic braininjury、 Crit Care Nurse 2007;27(1):30–7、 onset of dysautonomic paroxysms and various afferent stimuli, both noxious and non-noxious、 Such stimuli have included pain, endotracheal suctioning, passive movements such as turning, bathing and muscle stretching, constipation便秘 or a kinked catheter导尿, emotional stimuli , as well as environmental stimuli such as loud noises Laxe S, Terré R, León D, Bernabeu M、How does dysautonomia influence the oute of traumatic brain injured patientsadmitted in a neurorehabilitation unit?Brain Inj、 2013;27(12):1383-7、 All patients had been referred to the S、 Anna Institute – RAN in the years 1998–2005 for being in a VS/UWS condition、 PSH occurred in 26、1% of them, with greater incidence after traumatic than non-traumatic brain injury (31、9% vs 15、8%)、 Oute was worse following non