急性期及び回復期脊髄損傷患者におけるAutonomic Hyperreflexiaの薬物療法

概要

論文の詳細を見る
Autonomic hyperreflexia is a common complication of the high spinal cord lesion and sometimes may evoke convulsion, intracranial hemorrhage and death. This symptom is found in acute and in recovery stage of spinal injury and disappeared in chronic stage. Because of this reason, total spinal block or neurotomia in the lumbar area should not be chosen at first. The purpose of this study is to find out the trigger mechanism and drug therapy of autonomic hyperreflexia, particularly in the acute and recover phases. The blood pressure, pulse rate, gross sweating, plethysmogram and the vesical pressure were observed while the bladder was filled with normal saline at a rate of 30 ml per minute. Effects of phenoxybenzamine, atropine sulfate, bethanechol chloride, diazepam and percamine S were studied. The following results were obtained : 1) The patients were divided into two groups. The one showed paroxysmal hypertension after increase of bladder pressure and the other showed gross sweating without paroxysmal hypertension. 2) Among the various stimulation to the patients such as catheterization of the urethra, bladder distension, etc., the most effective trigger of the autonomic hyperreflexia was the vesicai contraction. 3) Phenoxybenzamine, diazepam and atropine sulfate are useful in the treatment of autonomic hyperreflexia for mainly reducing the urethral resistance or preventing abnormal contration of the badder. Administration of bethanechol chloride provoked strong blaclder contraction, and this might be due to its inhibitory action on cardiovascular system and this drug did not evoke severe paroxysmal hypertension. Percamine S is effective to autonomic hyperrefiexia by its action of blocking both sensory and motor nerves of the bladder.
社団法人日本泌尿器科学会の論文
1978-12-20

急性期及び回復期脊髄損傷患者におけるAutonomic Hyperreflexiaの薬物療法

スポンサーリンク

概要

著者

関連論文

スポンサーリンク