Federspil P A, Zenk J
Klinik und Poliklinik für HNO-Heilkunde, Universitätskliniken des Saarlandes, Homburg/Saar.
HNO. 1999 Oct;47(10):867-75. doi: 10.1007/s001060050527.
Hiccup is defined as involuntary contractions of the diaphragm and the auxiliary respiratory muscles, mostly in irregular series, followed by glottic closure, thereby producing a typical "hiccupping" inspiration. This is a physiologic phenomenon, which already exists in utero. Hiccup is believed to be a gastrointestinal reflex; however, function and the reflex arch are hypothetical. Acute hiccup is distinguished from pathological, chronic hiccup, defined by a duration executing 48 h, or recurrent episodes. Among approximately 100 causes for hiccup, the most common are located in the gastrointestinal tract, with gastro-esophageal reflux as the most important. While the respiratory effect is generally negligible, alkalosis may ensue in tracheotomized patients due to hyperventilation. A stepwise management plan for patients with hiccup is presented. If simple physical maneuvers and causal therapy fail, or causal therapy is impossible, the treatment of choice is medical, with baclofen. Interruption of the reflex arch may be causal therapy or be considered as a last resort.
呃逆被定义为膈肌和辅助呼吸肌的不自主收缩，大多呈不规则序列，随后声门关闭，从而产生典型的“打嗝”吸气。这是一种生理现象，在子宫内就已存在。呃逆被认为是一种胃肠反射；然而，其功能和反射弧是假设性的。急性呃逆与病理性慢性呃逆相区别，慢性呃逆定义为持续时间超过48小时或反复发作。在大约100种呃逆原因中，最常见的位于胃肠道，其中胃食管反流最为重要。虽然呼吸影响通常可忽略不计，但气管切开患者可能因过度通气而发生碱中毒。本文提出了呃逆患者的逐步管理计划。如果简单的物理手法和病因治疗失败，或病因治疗不可能进行，首选的治疗方法是药物治疗，使用巴氯芬。反射弧的中断可能是病因治疗或被视为最后手段。
