針灸治療外傷性脊髓損傷術後病例

目的：本篇報告一例外傷性脊髓損傷術後併四肢癱瘓，經針灸及復健治療得到良好療效之病例。臨床表現：一位28歲女性因車禍導致不完全性脊髓損傷併四肢癱瘓，經神經外科手術解除脊髓壓迫一個月後，四肢仍癱軟無力，入住復健科治療一星期後會診中醫針灸治療。治療過程與結果：病患於復健科住院期間結合針灸治療，並於家中自我復健訓練，經四個月後，肌力及巴氏量表明顯進步，右半身肌力0-1分進步至4分，左半身肌力2-4分進步至5分，巴氏量表0分進步至90分。因右手精細動作及感覺較差，繼續於針灸科門診治療2個月後，右手活動正常，肢體肌力、靈活度與生活自理能力均明顯改善，四肢肌力均?5分，巴氏量表100分，只遺留右上肢對痛或溫度感覺稍遲鈍的後遺症。結論：治療外傷性脊髓損傷術後併四肢癱瘓，早期結合針灸與復健可縮短復原時間。
Objective: This report of one case illustrates good curative effect of rehabilitation combined with acupuncture treatment for quadriplegia caused by traumatic spinal cord injury status post surgery. Clinical feature: A 28-year-old woman experienced quadriplegia caused by incomplete spinal cord injury in a traffic accident. One month after surgical decompression for her spinal cord injury, she still suffered from quadriplegia. She was transferred to rehabilitation ward; the intervention of acupuncture was performed followed by the consultation. Intervention and outcome: After 4 months rehabilitation therapy combined with acupuncture treatment, her muscle power was improved from 0/1/2/4 to 4/4/5/5 (RA/RL/LA/LL), Barthel Index was improved from 0 to 90. She continued acupuncture therapy for her limited tine movement and impaired sensation of right hand. Her muscle power and Barthel index were both full after another 2 months of acupuncture therapy at our OPD. Only her slightly impaired sensation of right hand was left. Conclusion: During the treatment for quadriplegia caused by traumatic spinal cord injury status post surgery, early intervention of acupuncture in rehabilitation can shorten the recovery period.