Levi R, Hultling C, Nash M S, Seiger A
Solberga Spinal Cord Injury Research Project, Karolinska Institute, Stockholm, Sweden.
Paraplegia. 1995 Jun;33(6):308-15. doi: 10.1038/sc.1995.70.
Out of a regional traumatic spinal cord injury population consisting of 379 individuals, 353 (93.1%) participated in the present study. Subjects were individually interviewed using semi-structured protocols. In addition, previous medical records were available for over 96% of subjects, and were used in all these cases to minimise recall bias. Cause of injury, prevalence of present medical symptoms and occurrence of medical complications in the post-acute, post-discharge phase were recorded. Neurological classification was verified by physical examination according to ASIA/IMSOP standards. Many subjects had experienced complications since discharge from initial hospitalisation, especially urinary tract infections, decubitus ulcers, urolithiasis, and neurological deterioration. Prevalence of medical symptoms was also high. More than 41% of subjects with spastic paralysis reported excessive spasticity to be associated with additional functional impairment and/or pain. Almost two-thirds of subjects reported significant pain, with a predominance of neurogenic-type pain. Bladder and bowel dysfunction were each rated by nearly 41% of subjects as a moderate to severe life problem. As expected, sexual dysfunction was also commonly reported. Prevalence of reported symptoms by general systems review was high, particularly fatigue, constipation, ankle oedema, joint and muscle problems, and disturbed sleep. However, lack of adequate normative data precludes comparison with the general population. The frequent occurrence of reported medical problems and complications support advocacy of comprehensive, life-long care for SCI patients. The commonly reported problems of neurogenic pain and neurological deterioration, in particular, require more attention, as these symptoms are not seldom ominous, either by virtue of their impact on quality of life, or because of underlying pathology.
在由379名个体组成的区域性创伤性脊髓损伤人群中，353人（93.1%）参与了本研究。使用半结构化方案对受试者进行单独访谈。此外，超过96%的受试者有既往病历，在所有这些病例中均使用病历以尽量减少回忆偏倚。记录损伤原因、当前医学症状的患病率以及急性后期、出院后阶段的医学并发症发生率。根据ASIA/IMSOP标准通过体格检查核实神经学分类。许多受试者自首次住院出院后出现了并发症，尤其是尿路感染、褥疮、尿路结石和神经功能恶化。医学症状的患病率也很高。超过41%的痉挛性瘫痪受试者报告痉挛过度与额外的功能障碍和/或疼痛有关。近三分之二的受试者报告有明显疼痛，以神经源性疼痛为主。近41%的受试者将膀胱和肠道功能障碍评为中度至重度生活问题。不出所料，性功能障碍也很常见。通过全面系统回顾报告的症状患病率很高，尤其是疲劳、便秘、脚踝水肿、关节和肌肉问题以及睡眠障碍。然而，由于缺乏足够的标准化数据，无法与一般人群进行比较。所报告的医学问题和并发症频繁出现，支持对脊髓损伤患者进行全面的终身护理。特别是神经源性疼痛和神经功能恶化这些常见报告问题需要更多关注，因为这些症状无论是因其对生活质量的影响，还是由于潜在的病理状况，都往往是不祥之兆。
