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題名 | Autonomic Dysreflexia Triggered by an Unstable Lumbar Spine in a Quadriplegic Patient=不穩定腰椎誘發一四肢癱瘓病人的自主神經異常反射 |
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作者 | 吳佩璇; 賴伯亮; 李麗芳; 許智欽; Wu, Katie P.; Lai, Po-liang; Lee, Li-fang; Hsu, Chih-chin; |
期刊 | 長庚醫學 |
出版日期 | 20050700 |
卷期 | 28:7 2005.07[民94.07] |
頁次 | 頁508-511 |
分類號 | 416.61 |
語文 | eng |
關鍵詞 | 自主神經異常反射; 非穩定性脊柱; 化膿性脊椎炎; 四肢癱瘓; Autonomic dysreflexia; Unstable spine; Pyogenic spondylitis; Quadriplegia; |
中文摘要 | 一位第五頸髓損傷併四肢癱瘓之40歲男性患者,因第二、三腰椎化震性脊柱炎接受脊椎切除固定及骨骼移植手術。3個月後,當病患坐立時,出現血壓上升、頭痛、冒汗等自主神經異常反射(autonomic dysreflexia)症狀。這些自主神經異常反射症狀於平躺後即減緩。腰椎X光影像顯示第二、三腰椎移骨頭有被吸收現象。經診斷為化膿性脊椎炎後,即對病人投予8星期之抗生素治療,待感染控制之後再進行脊椎固定術。病人自主神經異常反射於術後立即得到緩解。本文希望藉由探討非穩定性脊柱誘發自主神經異常反射症狀與臨床置,以作為處理類似脊髓損傷病患之參考。 |
英文摘要 | A 40 year-old man with C5 complete quadriplegia, had L2-L3 pyogenic spondylitis treated with debridement and fusion of the lumbar spine with left iliac bone graft. Three months later he developed symptoms of autonomic dysreflexia, including headacehe, cold sweating, and hypertension whenever he was in an upright lposition. These symptoms resolved after lying down. Roentgenograms of the lumbar spine revealed absorption of the bone graft at the L2-L3 level. A spinal stabilization procedure was done after eight weeks of antibiotic therepay under the impression of unstable spine caused by pyogenic spondylitis. Symptoms were relieved immediately following the surgery. This report may be helpful for physicians caring for quadriplegic patients with autonomic dysreflexia induced by an unstatble spine. |
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