Cavigelli A
Schweizerisches Paraplegikerzentrum, Universitätsklinik Balgrist, Zürich.
Schweiz Med Wochenschr. 2000 Jun 3;130(22):837-43.
While the consequences of damage to the sensorimotor nervous system in spinal cord injury are obvious, autonomic dysreflexia often goes unrecognised. Spinal cord injury affecting the cord above the fifth thoracic segment involves interruption of the connection between brain and sympathetic nervous system and, below the level of the lesion, the sacral parasympathetic nervous system. The isolated spinal cord continues to function, except for the directly damaged segment, but there is no central control. The autonomic nervous system below the level of the lesion can trigger severe reactions from the cardiovascular system which diminish quality of life and even promote severe morbidity. Autonomous malfunction can also have clinical effects in relation to thermoregulation and gastrointestinal, genital and urinary tract function.
虽然脊髓损伤中感觉运动神经系统受损的后果很明显,但自主神经反射异常常常未被识别。影响胸段第五节以上脊髓的损伤会中断大脑与交感神经系统之间的连接,以及损伤平面以下的骶副交感神经系统。除了直接受损的节段外,孤立的脊髓仍能继续发挥功能,但没有中枢控制。损伤平面以下的自主神经系统可引发心血管系统的严重反应,这会降低生活质量,甚至导致严重发病。自主功能障碍在体温调节以及胃肠、生殖和泌尿系统功能方面也会产生临床影响。