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学科主题: 临床医学
题名:
Iatrogenic urological triggers of autonomic dysreflexia: a systematic review
作者: Liu, N.1,2; Zhou, M.1; Biering-Sorensen, F.3; Krassioukov, A. V.2,4,5
刊名: SPINAL CORD
发表日期: 2015-07-01
DOI: 10.1038/sc.2015.39
卷: 53, 期:7, 页:500-509
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Rehabilitation
研究领域[WOS]: Neurosciences & Neurology ; Rehabilitation
关键词[WOS]: SPINAL-CORD-INJURY ; SHOCK-WAVE LITHOTRIPSY ; FATAL CEREBRAL-HEMORRHAGE ; REFLEX URINARY-BLADDER ; BLOOD-PRESSURE ; INTERNATIONAL STANDARDS ; TRANSURETHRAL LITHOLAPAXY ; URODYNAMIC EXAMINATIONS ; QUADRIPLEGIC PATIENTS ; ANORECTAL PROCEDURES
英文摘要:

Study design: This is a systematic review.

Objective: The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD).

Setting: This study was conducted in an international setting.

Methods: A systematic review was conducted from PubMed search using AD/autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood pressure (BP) assessments during urological procedures were excluded.

Results: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures. During urodynamics, the incidence of AD ranged from 36.7% to 77.8%. The symptomatic rate ranged from 50% to 65%, with AD symptoms seen predominantly in cervical SCI patients. The studies imply no consensus regarding the relationship between AD, neurogenic detrusor overactivity and detrusor sphincter dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other iatrogenic urological triggers were commonly associated with bladder filling.

Conclusion: The LUT triggers of episodes of AD are often associated with iatrogenic urological procedures. AD was more prevalent in cervical SCI than in thoracic SCI. To detect this potential life-threatening complication following cervical and high thoracic SCI, routine BP monitoring during urological procedures is highly recommended.

语种: 英语
项目资助者: China Scholarship Council ; International Collaboration on Research Discoveries (ICORD) ; University of British Columbia, Canada ; Canadian Institute of Health Research ; Canadian Heart and Stroke Foundation ; Craig Neilsen Foundation
WOS记录号: WOS:000357576200002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57476
Appears in Collections:北京大学第三临床医学院_康复医学科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Rehabil Med, Beijing 100871, Peoples R China
2.Univ British Columbia, Dept Med, ICORD, Vancouver, BC V5Z 1M9, Canada
3.Univ Copenhagen, Glostrup Hosp, Dept Spinal Cord Injuries, Copenhagen, Denmark
4.Univ British Columbia, Div Phys Med & Rehabil, Vancouver, BC V5Z 1M9, Canada
5.Vancouver Coastal Hlth, GF Strong Rehabil Ctr, Vancouver, BC, Canada

Recommended Citation:
Liu, N.,Zhou, M.,Biering-Sorensen, F.,et al. Iatrogenic urological triggers of autonomic dysreflexia: a systematic review[J]. SPINAL CORD,2015,53(7):500-509.
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