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[手足搐搦作为急诊会诊常见病因——病因、症状与治疗]

[Tetany as a frequent cause of an emergency consultations--etiology, symptoms and cure].

作者信息

Gryglas Anna, Dudkowiak Robert, Smigiel Robert

出版信息

Przegl Lek. 2015;72(1):20-4.

Abstract

Tetany is a disorder with a very heterogeneous clinical manifestation. It includes neuromuscular hyperactivity, decreased attention, fatigue, constant anxiety. Attacks of tetany range from mild symptoms, which includes circumoral and distal paresthesias, hyperventilation, accompanied by shortness of breath, palpitation, dizziness, nausea and carpopedal spasm, through more severe symptoms like generalized seizures, loss of consciousness, muscle crumps to life-threatening emergencies like laryngospasm or arrhythmias. Tetany can be a result of many electrolyte disturbances, like hypocalcaemia, hypomagnesemia, hypokalaemia, alkalosis and electrolyte disturbances following hyperventilation. These disorders may occur in many clinical situations including diet deficiencies, alcoholism, endocrine diseases, genetic disorders, iatrogenic causes like proton pump inhibitors therapy and many, many others. It happens that tetany is diagnosed too late and therefore insufficiently cured. For these reason it deserves closer attention.

摘要

手足搐搦症是一种临床表现非常异质性的疾病。它包括神经肌肉活动亢进、注意力下降、疲劳、持续焦虑。手足搐搦症的发作范围从轻症状,包括口周和远端感觉异常、换气过度,伴有呼吸急促、心悸、头晕、恶心和手足痉挛,到更严重的症状如全身性癫痫发作、意识丧失、肌肉痉挛,再到危及生命的紧急情况如喉痉挛或心律失常。手足搐搦症可能是多种电解质紊乱的结果,如低钙血症、低镁血症、低钾血症、碱中毒以及换气过度后的电解质紊乱。这些紊乱可能发生在许多临床情况下,包括饮食缺乏、酗酒、内分泌疾病、遗传性疾病、医源性原因如质子泵抑制剂治疗等等。有时手足搐搦症被诊断得太晚,因此治疗不充分。出于这些原因,它值得更密切的关注。

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