Williams G O
J Fam Pract. 1981 Feb;12(2):231-7.
Family physicians can help prevent spinal cord injuries by patient education about alcohol, drugs, seat belts, and football safety rules. Immobilization at the site of injury is essential to prevent incomplete cord injuries from becoming complete. Treatment is urgent; hemorrhagic necrosis of the cord is reversible only up to four hours after injury. Physicians must inform patients and families that regional spinal injuries centers provide the best care, with lowest total costs, and shortest hospital stay. Initial treatment includes immobilization, with or without surgery, prophylactic anticoagulants, and sometimes steroids and local hypothermia. Intermittent catheterization has revolutionized bladder control and reduced the incidence of infections. The most common causes of death are renal failure and pulmonary complications, sitting stability, strengthening non-paralyzed muscles, and providing equipment for maximum function. Psychologists, who work with families as well as patients in developing coping strategies, are important members of rehabilitation teams. Seventy percent of paraplegics return to the community within six months of injury, and nearly 50 percent achieve satisfactory sexual activity.
家庭医生可以通过对患者进行关于酒精、药物、安全带和足球安全规则的教育来帮助预防脊髓损伤。在损伤部位进行固定对于防止不完全性脊髓损伤发展为完全性损伤至关重要。治疗必须紧急进行；脊髓出血性坏死仅在损伤后四小时内是可逆的。医生必须告知患者及其家属，区域性脊髓损伤中心能提供最佳的治疗，费用最低，住院时间最短。初始治疗包括固定，可进行或不进行手术、预防性抗凝治疗，有时还包括使用类固醇和局部低温治疗。间歇性导尿彻底改变了膀胱控制方式并降低了感染发生率。最常见的死亡原因是肾衰竭和肺部并发症、坐位稳定性、增强未瘫痪肌肉的力量以及提供实现最大功能的设备。心理学家在帮助患者及其家人制定应对策略方面发挥着作用，是康复团队的重要成员。70%的截瘫患者在受伤后六个月内重返社区，近50%的患者实现了满意的性活动。
