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急性颈髓损伤与窦性心动过缓
http://www.100md.com 《创伤外科杂志》 2005年第1期
窦性心动过缓,,颈髓损伤;窦性心动过缓,1心血管的神经调节,2颈髓损伤所致窦性心动过缓的发病机制,3临床表现与治疗,4结论,参考文献:
     摘要: 创伤导致的严重的颈髓损伤(CSCI)会使脊交感神经下行通路中断和交感神经节前神经元发生短暂的萎缩,而迷走神经的传入和传出冲动不会受到任何影响,导致交感神经与副交感神经张力失衡,发生窦性心动过缓,被称之为压力反射迷走神经性心动过缓(BVB),严重者可出现心脏停搏。窦性心动过缓一般是发生于颈髓损伤后的1周以内,持续时间一般为7~10天。使用β-肾上腺能受体激动剂(如沙丁胺醇)激活心脏交感神经的活性,能获得良好的临床治疗效果。

    关键词: 颈髓损伤;窦性心动过缓

    Bradycardia associated with acute cervical spinal cord injury

    HU Pei-qun,YAN Liu-zi,WANG Ji

    (ICU,Tianjin Hospital,Tianjin 300211,China)

    Abstract: After severe cervical spinal cord injury(CSCI)the descending spinal sympathetic pathway can be inter-rupted,and an initial,transient atrophy of sympathetic preganglionic neurons was found.Unopposed parasympathetic tone may lead to overt bradycardia,a baroreflex vagal bradycardia(BVB)because of an intact vagal afferent and efferent pathway is in the CSCI patients.In extreme cases,this imbalance may result in cardiac arrest.The persistent bradycardia is found within the first week of post-injury and underwent7to10days.Management of the bradycardia withβ-adrenergic receptor agonist,such as salbutamol,to activate cardiac sympathetics may be more available.

    Key words:cervical spinal cord injury;bradycardia ......

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