Bergman S B, Yarkony G M, Stiens S A
New England Regional Spinal Cord Injury Center-Boston Medical Center, MA 02118, USA.
Arch Phys Med Rehabil. 1997 Mar;78(3 Suppl):S53-8. doi: 10.1016/s0003-9993(97)90410-x.
This self-directed learning module highlights new advances in understanding medical complications of spinal cord injury through the lifespan. It is part of the chapter on spinal cord injury rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article covers reasons for transferring patients to specialized spinal cord injury centers once they have been stabilized, and the management of common medical problems, including fever, autonomic dysreflexia, urinary tract infection, acute and chronic abdominal complications, deep vein thrombosis, pulmonary complications, and heterotopic ossification. Formulation of an educational program for prevention of late complications is also discussed, including late renal complications, syringomyelia, myelomalacia, burns, pathologic fractures, pressure ulcers, and cardiovascular disease. New advances covered in this section include new information on old problems, and a discussion of exercise tolerance in persons with tetraplegia, the pathophysiology of late neurologic deterioration after spinal cord injury, and a view of the care of these patients across the lifespan.
这个自主学习模块重点介绍了在整个生命周期中理解脊髓损伤医学并发症方面的新进展。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康复章节的一部分。本文涵盖了患者病情稳定后转至专业脊髓损伤中心的原因，以及常见医学问题的管理，包括发热、自主神经反射异常、尿路感染、急慢性腹部并发症、深静脉血栓形成、肺部并发症和异位骨化。还讨论了预防晚期并发症的教育计划的制定，包括晚期肾脏并发症、脊髓空洞症、脊髓软化、烧伤、病理性骨折、压疮和心血管疾病。本节涵盖的新进展包括关于旧问题的新信息，以及对四肢瘫痪者运动耐力的讨论、脊髓损伤后晚期神经功能恶化的病理生理学，以及对这些患者整个生命周期护理的观点。
