颈椎脊髓损伤患者自主神经性反射异常的临床处理

Treatment for autonomic dysreflexia after cervical spinal cord injury

目的 探讨颈椎脊髓损伤患者自主神经性反射异常（autonomic dysreflexia,AD）的临床诊治措施.方法 2006年9月～2011年9月,共诊治23例颈椎脊髓损伤后发生自主神经性反射异常的患者,主要措施为去除对张力感受器和痛觉感受器的不良刺激.结果 19例患者在去除不良刺激后1-5 min内症状完全缓解,其余4例患者经Ca2＋通道阻滞剂治疗后血压降致正常.结论对于颈椎脊髓损伤的患者,应注意观察并解除可能导致AD发生的因素;一旦诊断为AD,应尽快消除诱因并对症处理,避免出现并发症.

Objective To explore the treatment for autonomic dysreflexia（AD） after cervical spinal cord injury. Methods From September 2006 to September 2011,23 patients with cervical spinal cord injury were analyzed, the main therapy method was to remove harmful stimulus. Results After the treatment, 19 patients were completely released in 1-5 min, the rest 4 patients＇ blood pressure dropped to normal with the using of the calcium channel blockers. Conclusion In cervical spinal cord injury patients, the factors that could induce AD must be observed closely and removed as soon as possible. Once diagnosed as AD, inducement should be eliminated, and symptomatic treatment should be carried out as soon as possible, in order to avoid complication appeared.