Groah Suzanne L, Stiens Steven A, Gittler Michelle S, Kirshblum Steven C, McKinley William O
Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA 95118, USA.
Arch Phys Med Rehabil. 2002 Mar;83(3 Suppl 1):S82-9, S90-8. doi: 10.1053/apmr.2002.32182.
This self-directed learning module highlights consideration and treatment of individuals with long-term spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the challenges of chronic disease prevention, diagnosis, therapeutic options, and the resultant impact on the person with long-term SCI. With cardiovascular disease becoming a leading cause of mortality in this population, risk factor modification through weight, lipid, and glucose control becomes more important. Likewise, bowel dysfunction increases with duration and severity of SCI. Conservative and surgical management options are discussed. Musculoskeletal repetitive trauma injuries occur commonly in long-term SCI but can be prevented with appropriate lifestyle or equipment modifications. These and other conditions occurring in the person with long-term SCI are closely related to psychosocial function with resultant social isolation, depression, and substance abuse. Thus, identification and surveillance of these comorbidities are addressed, with an emphasis on prevention.
To summarize the unique medical, psychosocial, and functional needs of the individual with long-term SCI.
本自主学习模块重点介绍了长期脊髓损伤（SCI）患者的考量因素及治疗方法。它是针对物理医学与康复领域的从业者和学员的自主物理医学教育项目中脊髓损伤医学章节的一部分。本文特别关注慢性病预防、诊断、治疗选择以及对长期脊髓损伤患者的最终影响。随着心血管疾病成为该人群的主要死因，通过控制体重、血脂和血糖来改变风险因素变得更加重要。同样，肠道功能障碍会随着脊髓损伤的持续时间和严重程度而增加。本文讨论了保守和手术管理方案。肌肉骨骼重复性创伤损伤在长期脊髓损伤患者中很常见，但可以通过适当的生活方式或设备调整来预防。长期脊髓损伤患者出现的这些及其他病症与心理社会功能密切相关，会导致社会隔离、抑郁和药物滥用。因此，本文探讨了这些合并症的识别和监测，重点是预防。
总结长期脊髓损伤患者独特的医疗、心理社会和功能需求。
