ID | 32867 |
JaLCDOI | |
フルテキストURL | |
著者 |
Furusawa, Kazunari
Kibikogen Rehabilitation Center for Employment Injuries
Sugiyama, Hiroyuki
Kibikogen Rehabilitation Center for Employment Injuries
Ikeda, Atsushi
Kibikogen Rehabilitation Center for Employment Injuries
Tokuhiro, Akihiro
Kibikogen Rehabilitation Center for Employment Injuries
Koyoshi, Hiroko
Kibikogen Rehabilitation Center for Employment Injuries
Takahashi, Masanori
University of Occupational and Environmental Health
Tajima, Fumihiro
Wakayama Medical University
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抄録 | The purpose of the present study was to investigate the relationship between bowel maneuvers and autonomic dysreflexia (AD) in patients with cervical spinal cord injuries (CSCI). Fifteen consecutive, clinically stable patients with CSCI participated. We evaluated changes in blood pressure (BP), pulse rate (PR) and classic symptoms of AD before, during and after a bowel program involving the manual removal of stool in lateral recumbency. The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation. Furthermore, the manual removal of stool induced AD, with maximal increases of systolic BP (169.1(+-)19.5 mmHg, mean(+-)SD). However, the insertion of a finger into the anus after the end of stool flow did not cause a further increase in systolic BP. Systolic BP recovered to pre-program values within 5 min after defecation. Our study demonstrated that the combined effects of rectal and/or anal sphincter distension and uninhibited rectal contraction in response to the manual removal of stool might induce AD. We recommend avoiding, if at all possible, the manual removal of stool in order to prevent AD in patients with CSCI.
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キーワード | spinal cord injury
autonomic dysrefl exia
blood pressure
bowel program
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Amo Type | Original Article
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出版物タイトル |
Acta Medica Okayama
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発行日 | 2007-08
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巻 | 61巻
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号 | 4号
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出版者 | Okayama University Medical School
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開始ページ | 221
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終了ページ | 227
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ISSN | 0386-300X
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NCID | AA00508441
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資料タイプ |
学術雑誌論文
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言語 |
英語
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論文のバージョン | publisher
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査読 |
有り
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PubMed ID | |
Web of Science KeyUT |