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剖宫产硬膜外麻醉后出现短暂性轻瘫的患者对育儿技能的掌握情况

Acquisition of Childcare Skills by a Patient With Transient Paraparesis Following Epidural Anesthesia for Cesarean Section.

作者信息

Kitade Ippei, Yamaguchi Tomoko, Shirafuji Aya, Endo Yoshinori, Arishima Hidetaka

机构信息

Division of Rehabilitation Medicine, University of Fukui Hospital, Fukui, JPN.

Department of Advanced Medicine for Community Healthcare, University of Fukui, Fukui, JPN.

出版信息

Cureus. 2025 Apr 10;17(4):e82036. doi: 10.7759/cureus.82036. eCollection 2025 Apr.

Abstract

For first-time mothers, every aspect of childcare is a new experience, and acquiring these skills can be physically and mentally challenging. It is reasonable to assume that patients with disabilities, including those experiencing lower-limb paraparesis, may face even greater difficulty mastering the physical movements required for childcare while simultaneously striving to regain independence in daily living. We report the case of a 29-year-old woman who developed lower limb paraparesis following an elective caesarean section and describe her recovery in limb function, activities of daily living (ADLs), and childcare skills. She was fully independent in ADLs preoperatively. On postoperative day 1, she experienced lower-limb weakness and sensory disturbances. Physical therapy commenced on day 5, and by week 2, she could perform childcare tasks such as holding, diaper changing, and breastfeeding while seated. By week 3, she was discharged with a wheelchair and walker. She was able to perform ADLs independently by week five. By week 10, she could perform childcare tasks while standing, though lifting and carrying her child remained difficult until week 15 due to physical and psychological factors. Epidural anesthesia after caesarean section facilitates early mobilization but may cause complications. This case highlights the need for standardized childcare assessments and structured rehabilitation programs.

摘要

对于初为人母者而言,育儿的方方面面都是全新体验,掌握这些技能可能在身体和心理上都具有挑战性。可以合理推测,残疾患者,包括那些下肢轻瘫的患者,在努力恢复日常生活自理能力的同时,掌握育儿所需的身体动作可能会面临更大困难。我们报告了一例29岁女性在择期剖宫产术后出现下肢轻瘫的病例,并描述了她在肢体功能、日常生活活动(ADL)和育儿技能方面的恢复情况。术前她在日常生活活动方面完全自理。术后第1天,她出现下肢无力和感觉障碍。第5天开始进行物理治疗,到第2周时,她能够坐着完成诸如抱孩子、换尿布和母乳喂养等育儿任务。到第3周时,她带着轮椅和助行器出院。到第5周时,她能够独立完成日常生活活动。到第10周时,她能够站着完成育儿任务,不过由于身体和心理因素,直到第15周时抱起和抱起孩子仍有困难。剖宫产术后硬膜外麻醉有助于早期活动,但可能会引起并发症。该病例凸显了标准化育儿评估和结构化康复计划的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5feb/12065637/9e844eea2a20/cureus-0017-00000082036-i01.jpg

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