四肢麻痺患者における反射性心停止のメカニズム
Lancet (London, England)
|December 13, 1975
まとめ
呼吸器で呼吸している高頸椎脊髄損傷の患者は,気管刺激によるブラジカルディアまたは心臓停止を経験することがあります. アトロピンと十分な酸素供給は,これらの危険な反応を防ぐことができます.
科学分野:
- 神経学 神経学とは
- 心臓病学 心臓病学
- 呼吸器医学とは
背景:
- 高頸椎脊髄病変は,自律神経系の制御を妨害する.
- これらの傷を負った患者は,しばしば機械呼吸器を必要とします.
- トラキア刺激は,この集団において有害な心血管疾患を誘発する可能性があります.
研究 の 目的:
- 高い頸椎脊髄損傷を有する患者の気管刺激後のブラジカルディアと心臓停止のメカニズムを調査する.
- アトロピンと適切な酸素化の有効性を評価し,これらの出来事を予防する.
主な方法:
- 絶え間ない正圧換気が必要とする完全高頸椎脊髄損傷を有する4人の患者の観察.
- 脊髄ショック中の気管管刺激に対する心血管反応のモニタリング.
- 観察された反射における低酸素と人工呼吸器の役割の評価.
主要な成果:
- トラキア刺激はすべての患者でブラディカルディアを誘発し,2人の患者で心停止に至った.
- ブラディカルディアは,正常な交感性活動に阻まれない低酸素と静脈反射と関連していました.
- 人工呼吸器は,低酸素期における肺回体反射活動の通常の増加を防ぎました.
結論:
- これらの患者では,補償性シンパシー活動と肺回体反射活動の増加が低下しています.
- ブラジカルディアと心停止を予防するために,適切な酸素化と予防的アトロピンが推奨されます.
- 緊急治療には,これらの心血管合併症を管理するためにアトロピンの投与が含まれます.
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