挤压综合征合并创伤性脊髓损伤个性化 康复治疗1例

A Case of Personalized Rehabilitation Therapy for Crush Syndrome Complicated with Traumatic Spinal Cord Injury

摘要: 目的：探索危重挤压综合征合并颈脊髓损伤患者的康复思路。方法：报道1例危重挤压综合征合并颈脊髓损伤的患者。因“外伤致四肢活动障碍10天”入院，伴急性肾功能不全、创伤性肺炎。康复诊断为四肢运动、呼吸、二便及ADL功能障碍。治疗采用康复综合方案，通过各种理疗手段结合针灸、无创神经调控等治疗恢复患者的功能。结果：经治疗，患者下肢肿胀消退，肾功能损伤好转，肺功能指标显著改善，上下肢肌力及二便功能较前改善，ADL评分提升。结论：对于危重挤压综合征合并颈脊髓骨折的患者，除肌肉力量康复治疗，还需兼顾对坏死肌肉的恢复治疗。采用早期、综合、个体化并融合中西医方法的康复方案，可能有助于改善此类患者的各项功能指标，提示该综合方案具有潜在的应用价值，可提高患者的生活质量。

Abstract: Objective: To investigate the rehabilitation strategies for critically ill patients with crush syndrome complicated by cervical spinal cord injury (CSCI). Methods: We report a case of a patient with crush syndrome complicated by cervical spinal cord injury. The patient was admitted, presenting with “limb mobility impairment due to trauma lasting 10 days”. The patient was accompanied by acute renal insufficiency and traumatic pneumonia. Rehabilitation diagnoses included dysfunction of limb motor function, respiration, bowel/bladder control, and activities of daily living (ADL). A comprehensive rehabilitation protocol was implemented, utilizing various physical therapies integrated with acupuncture and non-invasive neuromodulation to restore functional capacity. Results: Following treatment, lower limb edema subsided, renal function improved, and pulmonary function indices showed marked amelioration. Muscle strength of the upper and lower limbs and bowel/bladder functions were notably improved compared to baseline, and the ADL score increased. Conclusion: For patients with critical crush syndrome combined with cervical spinal fracture, rehabilitation should focus not only on muscle strength recovery but also on the repair of necrotic muscle tissue. An early, comprehensive, and individualized rehabilitation regimen that integrates traditional Chinese and Western medicine may help improve various functional outcomes in such patients. This suggests that the integrated approach holds potential clinical application value and could contribute to enhanced quality of life.