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脊髓损伤患者的妊娠与自主神经反射亢进

Pregnancy and autonomic hyperreflexia in patients with spinal cord lesions.

作者信息

Wanner M B, Rageth C J, Zäch G A

机构信息

Swiss Paraplegic Centre, Basel.

出版信息

Paraplegia. 1987 Dec;25(6):482-90. doi: 10.1038/sc.1987.81.

Abstract

Symptoms of autonomic hyperreflexia in patients with complete and incomplete paraplegia above D 7 can be caused by almost any stimulus in the abdominal area or in the lower extremities, specifically during parturition by the uterine contractions. The symptoms vary from pilo-erection and outbreaks of sweating to serious blood pressure crises and cerebrovascular accidents. Epidural anaesthesia and general anaesthesia are effective as therapy and also as prophylaxis. Frequent complications are anemia and urinary tract infections. Changes in bladder function as a result of pregnancy and childbirth were observed. Paraplegic expectant mothers experience premature labour pains more frequently than do others, and this implies the necessity for earlier clinical surveillance up to the time of delivery. The secondary uterine inertia frequently requires an operative termination of the birth. The perception of labour pains is clearly possible also with lesions above D 10.

摘要

胸7以上完全性和不完全性截瘫患者的自主神经反射亢进症状,几乎可由腹部或下肢的任何刺激引发,尤其是分娩时的子宫收缩。症状从竖毛、出汗发作到严重的血压危机和脑血管意外不等。硬膜外麻醉和全身麻醉作为治疗方法以及预防措施均有效。常见并发症为贫血和尿路感染。观察到妊娠和分娩导致膀胱功能发生变化。截瘫孕妇比其他孕妇更频繁地经历早产阵痛,这意味着在分娩前需要更早进行临床监测。继发性子宫收缩乏力常常需要手术结束分娩。胸10以上损伤的患者也显然能够感知分娩疼痛。

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