高脊髓损伤导致昏迷:对于心脏起器插入来说,这是一个罕见的征兆
Isa Khan1, Timothy G Scully2, Andrew W Teh1
1Cardiology, Austin Health, Heidelberg, Victoria, Australia.
BMJ case reports
|October 10, 2023
概括
心脏节拍在患有C2脊髓损伤的患者中有效地控制了昏,解决了自主功能障碍和胸. 这一案例凸显了节奏作为脊髓损伤患者反射失眠的潜在治疗方法.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 自主神经科学 自主神经科学
背景情况:
- 血管综合症管理指南通常为患有白心脏发作的患者保留心脏节奏.
- 高脊髓损伤 (SCI) 可以导致自主功能障碍,其特征是交感性低活性.
- 在SCI之后的自主功能障碍可能会导致心肌梗塞,导致血液动力学不稳定性和昏迷.
研究的目的:
- 调查心脏节拍在管理高脊髓损伤后与自主功能障碍相关的昏迷中的潜力.
- 探索SCI患者无对立的副交感信号和反射失眠之间的联系.
主要方法:
- 一个50多岁的男性患者的病例报告,有C2脊髓损伤的病史.
- 患者呈现低血压和昏迷,最初怀疑是败血症休克.
- 诊断评估表明由于自主功能障碍而引起的深度反射失眠; 进行了永久的心脏起器植入.
主要成果:
- 在永久心脏起器植入后,患者的血液动力学状况稳定.
- 患者在干预后没有经历过进一步的昏迷情节.
- 心脏节拍在这个SCI患者的昏迷管理中被证明是有效的.
结论:
- 心脏节拍可以是一个可行的治疗选择,用于管理高脊髓损伤和相关自主功能障碍的患者的反射失眠.
- 这一案例表明,来自无阻碍的副交感活动的深度胸是SCI相关昏的关键机制.
- 需要进一步的研究,以确定心脏节奏在脊髓损伤患者经历昏迷的更广泛人群中的作用.
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