人類打嗝(hiccup or singultus)的目的與作用的機轉至今仍未有定論,偶而的打嗝乃是很常見的生理現象,並不需要特別的治療。但在少數的情形,打嗝會持續不斷,此時我們稱之為頑固性打嗝,其症狀本身不但會困擾患者,導致食慾下降、失眠或心律不整等等,還可能是嚴重的耳鼻喉、呼吸道、胃腸或神經系統病變的臨床表徵之一。因此,在臨床上遇到頑固性打嗝時,應要詳盡地評估與治療。本文中將報告一個案在患有腦幹缺血性中風後,伴隨有頑固性打嗝,影響其營養與精神狀態,進而延遲中風復健的訓練,經給予低劑量的 prochlorperazine maleate (Novamin)治療後,成功地控制住打嗝的症狀,改善復健的進度。我們將進一步探討此病例可能的致病機轉,以及打嗝的神經控制;並回顧文獻中,關於頑固性打嗝的原因與治療的情況。
Hiccups are a common phenomenon though their mechanism and physiological meaning are still controversial. No special treatment is necessary for most patients with hiccup. However, the hiccup might last for more than one month in rare cases, defined as an intractable hiccup, as one of the clini-cal manifestations of respiratory, gastrointestinal or neurological diseases. A case with an ischemic brain stem stroke is investigated herein. The intractable hiccup disturbed the patient’s appetite, impaired his nutritional and dehydration status, and even delayed rehabilitation. Prochlorperazine maleate (Novamin) was administered and provided with much significant relief, which is the first successful experience in the management of hiccup to our knowledge. The possible path-ogenesis of intractable hiccups is defined and a management program for the intractable hiccup is also provided herein.
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