Amzallag M
Department of Anesthesiology, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Int Anesthesiol Clin. 1993 Winter;31(1):87-102. doi: 10.1097/00004311-199331010-00009.
Autonomic hyperreflexia presents as acute episodes of uninhibited reflex sympathetic hyperactivity in the patient with chronic high spinal cord lesion. An understanding of the pathophysiology of this syndrome is paramount in its successful management. It occurs in patients with chronic spinal cord lesions above T7 upon stimulation below the lesion, particularly distention of the urinary bladder. The main clinical signs are paroxysmal hypertension and bradycardia. Management of acute episodes should include withdrawal of the initiating stimulus and possibly administration of pharmacological agents such as nifedipine and nitroprusside. Long-term treatment may involve radical surgery. Despite its technical difficulties, spinal block is still the anesthesia of choice in these patients.
自主神经反射亢进表现为慢性高位脊髓损伤患者出现不受抑制的反射性交感神经过度活动的急性发作。了解该综合征的病理生理学对于其成功治疗至关重要。它发生在T7以上慢性脊髓损伤的患者中，在损伤平面以下受到刺激时，尤其是膀胱扩张时。主要临床体征为阵发性高血压和心动过缓。急性发作的治疗应包括去除引发刺激，并可能给予硝苯地平和硝普钠等药物。长期治疗可能需要进行根治性手术。尽管存在技术困难，但脊髓阻滞仍是这些患者的首选麻醉方法。
