Leung Alexander K C, Leung Amy A M, Wong Alex H C, Hon Kam L
Department of Pediatrics, The University of Calgary and The Alberta Children's Hospital, Calgary, Alberta, Canada.
Department of Family Medicine, The University of Alberta, Edmonton, Alberta, Canada.
Curr Pediatr Rev. 2020;16(4):277-284. doi: 10.2174/1573396316666200508112951.
Hiccups are a universal phenomenon. They are usually benign and selflimited. Persistent or intractable hiccups, although rare, can be debilitating and may indicate the presence of an underlying pathological process.
To familiarize physicians with the pathophysiology, etiology, evaluation, and management of children with hiccups.
A search was conducted on December 10, 2019, in Pubmed Clinical Queries using the key terms "hiccup" OR "hiccough" OR "singultus". The selected publication types included all clinical trials (including open trials, non-randomized controlled trials, and randomized controlled trials), observational studies, and reviews (including meta-analysis and narrative reviews) published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.
Overdistension of the stomach is the most commonly identifiable cause of acute hiccups, followed by gastroesophageal reflux and gastritis. Other causes of hiccups, notably persistent and intractable hiccups, include an underlying gastrointestinal, neurological, cardiovascular, pulmonary, infectious, and psychogenic disorder. Persistent or intractable hiccups can be a harbinger of serious medical pathology. A detailed history and thorough physical examination may provide clues for the etiology of the hiccups. The treatment of hiccups should be directed at the underlying cause whenever possible. Bouts of acute hiccups less than 48 hours rarely require medical intervention as they usually resolve within minutes. Treatment may be considered when hiccups are bothersome, persistent, or intractable. Treatment modalities include lifestyle changes, physical maneuvers, pharmacotherapy and, very rarely, surgical intervention.
Acute hiccups are usually benign and self-limiting. Persistent or intractable hiccups can be a harbinger of serious medical pathology. The underlying cause should be treated if possible. There are no formal guidelines for the treatment of hiccups. Currently, most of the methods proposed are based on case reports and anecdotal evidence. Terminating an episode of hiccups can be very challenging for a clinician but may tremendously improve the patient's quality of life. It is hoped that future well-designed and better-powered studies will provide us with more information on the efficacy of various treatment modalities for hiccups.
打嗝是一种普遍现象。通常为良性且自限性。持续性或顽固性打嗝虽罕见，但可能使人虚弱，且可能提示存在潜在病理过程。
使医生熟悉儿童打嗝的病理生理学、病因、评估及管理。
于2019年12月10日在Pubmed临床查询中使用关键词“hiccup”或“hiccough”或“singultus”进行检索。所选发表类型包括过去10年内发表的所有临床试验（包括开放试验、非随机对照试验和随机对照试验）、观察性研究及综述（包括荟萃分析和叙述性综述）。本综述仅纳入英文文献发表的论文。从上述检索中获取的信息用于撰写本文。
胃过度扩张是急性打嗝最常见的可识别病因，其次是胃食管反流和胃炎。打嗝的其他病因，尤其是持续性和顽固性打嗝，包括潜在的胃肠道、神经、心血管、肺部、感染及精神性疾病。持续性或顽固性打嗝可能是严重医学病变的先兆。详细的病史和全面的体格检查可为打嗝的病因提供线索。打嗝的治疗应尽可能针对潜在病因。持续时间少于48小时的急性打嗝发作很少需要医学干预，因为它们通常在数分钟内自行缓解。当打嗝令人烦恼、持续或顽固时可考虑治疗。治疗方式包括生活方式改变、物理手法、药物治疗，极少数情况下采用手术干预。
急性打嗝通常为良性且自限性。持续性或顽固性打嗝可能是严重医学病变的先兆。如有可能应治疗潜在病因。目前尚无关于打嗝治疗的正式指南。当前，多数提出的方法基于病例报告和轶事证据。对于临床医生而言，终止一次打嗝发作可能极具挑战性，但可能极大改善患者生活质量。希望未来设计良好且更具说服力的研究能为我们提供更多关于各种打嗝治疗方式疗效的信息。
