International Collaboration On Repair Discoveries, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, Canada.
World J Urol. 2024 Feb 15;42(1):80. doi: 10.1007/s00345-024-04781-0.
Spinal cord injury (SCI) leads to sensorimotor impairments; however, it can also be complicated by significant autonomic dysfunction, including cardiovascular and lower urinary tract (LUT) dysfunctions. Autonomic dysreflexia (AD) is a dangerous cardiovascular complication of SCI often overlooked by healthcare professionals. AD is characterized by a sudden increase in blood pressure (BP) that can result in severe cardiovascular and cerebrovascular complications. In this review, we provide an overview on the clinical manifestations, risk factors, underlying mechanisms, and current approaches in prevention and management of AD.
After conducting a literature research, we summarized relevant information regarding the clinical and pathophysiological aspects in the context of urological clinical practice CONCLUSIONS: The most common triggers of AD are those arising from LUT, such as bladder distention and urinary tract infections. Furthermore, AD is commonly observed in individuals with SCI during urological procedures, including catheterization, cystoscopy and urodynamics. Although significant progress in the clinical assessment of AD has been made in recent decades, effective approaches for its prevention and treatment are currently lacking.
脊髓损伤 (SCI) 可导致感觉运动功能障碍；然而，它也可能伴有严重的自主功能障碍，包括心血管和下尿路 (LUT) 功能障碍。自主反射亢进 (AD) 是 SCI 的一种严重心血管并发症，常被医疗保健专业人员忽视。AD 的特征是血压 (BP) 突然升高，可导致严重的心血管和脑血管并发症。在这篇综述中，我们概述了 AD 的临床表现、危险因素、潜在机制以及目前在预防和管理 AD 方面的方法。
在进行文献研究后，我们总结了与泌尿科临床实践背景下的临床和病理生理方面相关的信息。
AD 的最常见触发因素是来自 LUT 的因素，如膀胱膨胀和尿路感染。此外，AD 在接受泌尿科手术的 SCI 患者中很常见，包括导尿、膀胱镜检查和尿动力学检查。尽管近年来在 AD 的临床评估方面取得了重大进展，但目前仍缺乏有效的预防和治疗方法。
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