PDF(Pubmed)
Abstract：
Hiccups, a common and usually self-limiting condition, are caused by involuntary, spasmodic contractions of the diaphragm and intercostal muscles, followed by the sudden closure of the glottis. While most cases resolve spontaneously, persistent hiccups (lasting 48 hours to one month) and intractable hiccups (lasting more than one month) require medical attention. Intractable hiccups, although rare, can significantly impair a patient\'s quality of life. The etiology of intractable hiccups is diverse, but they are often associated with serious underlying medical conditions, such as severe renal dysfunction and uremia. We present the case of a 72-year-old male patient with stage IV chronic kidney disease (CKD) who developed intractable, violent hiccups following a mild COVID-19 infection. Despite treatment attempts with chlorpromazine and baclofen, the hiccups persisted for five months and only resolved after the initiation of hemodialysis. Interestingly, the patient\'s renal function deteriorated significantly during the period of hiccup persistence, suggesting a possible link between the hiccups and the progression of CKD, likely exacerbated by COVID-19. This case highlights the challenges of managing intractable hiccups in patients with advanced CKD and emphasizes the importance of addressing underlying metabolic derangements in such complex clinical scenarios. Moreover, it contributes to the growing evidence supporting the role of dialysis in resolving intractable hiccups associated with severe renal dysfunction.
摘要：
打嗝,一种常见的，通常是自我限制的情况，是由非自愿引起的，膈肌和肋间肌痉挛收缩，随后声门突然关闭。虽然大多数情况下自发解决，持续性打嗝（持续48小时至1个月）和顽固性打嗝（持续1个月以上）需要医疗护理。顽固性打嗝,虽然罕见，会严重损害患者的生活质量。顽固性打嗝的病因多种多样,但它们通常与严重的潜在医疗条件有关，如严重肾功能不全和尿毒症。我们介绍了一个72岁的男性患者，患有IV期慢性肾脏疾病（CKD），轻度COVID-19感染后剧烈打嗝。尽管尝试使用氯丙嗪和巴氯芬进行治疗，打嗝持续5个月,只有在血液透析开始后才得以缓解.有趣的是,患者的肾功能在持续打嗝期间显著恶化，表明打嗝和CKD进展之间可能存在联系，可能因COVID-19而加剧。该病例强调了晚期CKD患者治疗顽固性打嗝的挑战，并强调了在这种复杂的临床情况下解决潜在代谢紊乱的重要性。此外，越来越多的证据支持透析在解决与严重肾功能不全相关的顽固性打嗝中的作用.
