척수손상환자에서 자율신경성 반사부전증의 일반적 특성

Abstract

In this study on attempt was made to evaluate and manage autonomic dysreflexia in spinal cord injury through investigation and analysis of urodynamic studies. The subjects of this study were 91 patients with spinal cord lesions above the 7th thoracic segment who were admitted to the Rehabilitation Hospital, Yonsei Medical Center between Mar 1, 1993 and Dec 31, 1994.

The results are as follows:

The subjects with autonomic dysreflexia were 27 male and 6 female patients including 19 complete and 14 incomplete spinal cord injured patients. The trigger factors of autonomic dysreflexia were bladder distension, bladder percussion, rectal distension, ingrowing nail. Autonomic dysreflexia occurred more frequently in quadriplegics than in high paraplegics. The patients with severe spasticity had a high incidence of autonomic dysreflexia. Mean bladder pressure was significantly higher in patients with autonomic dysreflexia and mean bladder compliance was also significantly lower in this group.

Our data shows that autonomic dysreflexia is more frequently encountered in quadriplegics. Therefore, careful evaluation for autonomic dysreflexia is a necessity in this group. Also urodynamic studies can be valuable to detect autonomic dysreflexia in patients with spinal cord lesion above the 7th thoracic segment.