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
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
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
诊断性检查
首要检查
- 临床诊断
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
治疗流程
良性呃逆
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.
鉴别诊断
- 喘息
- 打嗝
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