骶骨下段临床检查的重要性：四例病例报告。
The importance of the clinical examination of the lower sacral segments: Four case reports.
作者信息
Andrade Maria João, Soares Tiago Felix
机构信息
a Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto , Porto , Portugal.
b PM&R Department , Centro Hospitalar do Porto , Porto , Portugal.
出版信息
J Spinal Cord Med. 2019 Jan;42(1):123-127. doi: 10.1080/10790268.2018.1432306. Epub 2018 Feb 6.
CONTEXT
In our practice, in a spinal cord injury unit, clinical examinations include anal sensation and voluntary anal contraction, which are essential for neurological classification of spinal cord injury according to international standards (ISNCSCI), but we also always examine the integrity of the sacral segments, testing anal tone and anal and bulbocavernosus reflexes (S2-S4 segments) and the dartos reflex to evaluate the thoracolumbar sympathetic pathway.
FINDINGS
In this paper, we describe four case reports of bladder dysfunction in which a clinical examination of the lower sacral segments was decisive to identify the neurological etiology.
CONCLUSION/CLINICAL RELEVANCE: These cases, in patients with unexplained bladder dysfunction, highlight the importance of clinical testing the sacral segments, as part of the neurological examination, otherwise sacral lesions may remain undetected.
背景
在我们脊髓损伤科的临床实践中，临床检查包括肛门感觉和肛门自主收缩，这对于根据国际标准（ISNCSCI）对脊髓损伤进行神经学分类至关重要，但我们也总是检查骶段的完整性，测试肛门张力、肛门和球海绵体反射（S2 - S4节段）以及肉膜反射以评估胸腰交感神经通路。
研究结果
在本文中，我们描述了4例膀胱功能障碍的病例报告，其中对骶下段的临床检查对于确定神经学病因起了决定性作用。
结论/临床意义：这些病例发生在不明原因膀胱功能障碍的患者中，突出了作为神经学检查一部分对骶段进行临床检测的重要性，否则骶段病变可能仍未被发现。
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