呃逆

最后审阅: 7 一月 2023
最后更新: 29 七月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 嗝喽”声
更多 关键诊断因素

其他诊断因素

  • 持续时间 <48 小时(通常为良性呃逆)
  • 持续时间 >48 小时(慢性呃逆)
  • 在睡眠中仍持续
  • 潜在病因的相关特点
  • 体重减轻和营养不良
其他诊断因素

危险因素

  • 吞气症,温度变化,情绪状态
  • 横膈以及膈神经的刺激
  • 迷走神经的刺激
  • 中枢神经系统病变
  • 代谢性/电解质紊乱
  • 毒素/药物
  • 心因性障碍
  • 镇静或麻醉
更多 危险因素

诊断性检查

首要检查

  • 临床诊断
更多 首要检查

需考虑的检查

  • 全血细胞计数 (FBC)
  • 血清电解质
  • 尿素
  • C 反应蛋白和红细胞沉降率
  • 肝功能检查
  • γ-谷氨酰转肽酶(γ-GT)
  • 血清淀粉酶
  • 毒理学筛查
  • 动脉血气
  • 心电图 (ECG)
  • 胸部 X 线检查
  • 肺功能检查 (PFT)
  • 腹部 CT
  • 上消化道内窥镜检查
  • 头部 CT 或 MRI(核磁共振)
  • 腰椎穿刺:
  • 耳镜检查
  • 咽喉镜检查
更多 需考虑的检查

治疗流程

急症处理

良性呃逆

持续性治疗

慢性呃逆

撰稿人

作者

Aminah Jatoi, MD

Professor of Oncology

Department of Oncology

Mayo Clinic

Rochester

MN

利益声明

AJ has received a grant review for Pfizer (money is paid to her institution) and research funding from AstraZeneca. AJ is on an advisory board for Meter Health and Novartis. AJ is an author of one reference cited in this topic.

鸣谢

Professor Aminah Jatoi would like to gratefully acknowledge Professor Peter Kranke, Dr Yvonne Jelting, and Dr Thomas M. Metterlein, previous contributors to this topic.

利益声明

PK is an author of a reference cited in this topic. YJ and TMM declare that they have no competing interests.

同行评议者

Andy Smith, BM, BS, MRCP, FRCA

Consultant Anaesthetist and Associate Director of Research and Development

Director

Lancaster Patient Safety Research Unit

Royal Lancaster Infirmary

Lancaster

UK

利益声明

AS declares that he has no competing interests.

Stefan K. Burgdorf, MD

Registrar

Department of Surgical Gastroenterology

Herlev Hospital

University of Copenhagen

Denmark

利益声明

SKB declares that he has no competing interests.

Howard Smith, MD, FACP

Academic Director of Pain Management

Associate Professor of Anesthesiology

Department of Anesthesiology

Albany Medical College

Albany

NY

利益声明

HS is an author of a reference cited in this topic.

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