Intractable hiccups should be alert to central system diseases, phrenic nerve injury, intractable hiccups occurring after surgery should also be considered postoperative complications. 1. Central system diseases: patients with trauma to the central nervous system above 3-5 cervical medulla; cerebrovascular hemorrhage, compression or cerebral thrombosis involving the medullary phrenic nerve reflex center; high cervical spine tumors, posterior cranial fossa tumors, direct invasion or high cranial pressure caused by the stimulation of the medullary phrenic nerve reflex center can lead to intractable diaphragmatic spasms; brain abscess, tuberculous meningitis, or due to intoxication, general anesthesia, uremia, ketoacidosis, hypocalcemia, low magnesium, and other factors that directly or indirectly stimulate phrenic nerve reflex. Cerebral abscess, tuberculosis meningitis, or due to intoxication, general anesthesia, ketosis, low calcium, low magnesium and other factors directly or indirectly stimulate the phrenic nerve reflex center, which can induce diaphragmatic spasm. 2. Phrenic nerve factors: direct stimulation of phrenic nerve in cervical and thoracic diseases, such as: pleurisy, pneumonia, myocardial infarction, thyroid, mediastinal, pulmonary portal surgery. Abdominal diseases or surgeries stimulate the peritoneum under the diaphragm where the phrenic nerve sensory nerves are distributed, gallbladder, etc., which can be seen in subphrenic abscess, peritonitis, gastrointestinal obstruction, gastric cancer. 3. Postoperative complications: postoperative eructation is relatively common, and the eructation that occurs within 8 to 12 hours after operation is mostly considered as nerve stimulation reflex. If the eructation lasts for a long time after surgery, we should consider whether there is gastric retention or gastric dilatation. If there is persistent hiccups after upper abdominal surgery, it is important to be alert to the possibility of an anastomotic or duodenal stump leakage, which may lead to subphrenic infection. In this case, CT or ultrasonography should be done to help diagnose the problem. Patients are advised to go to regular hospitals for treatment according to their symptoms.