脊髄損傷のリスク管理

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床ずれ管理
基本的には体位変換。放置すると感染を伴い骨髄炎を合併する。

起立性低血圧
静脈管流の低下により座位や立位になると血圧が低下する。失神もある。早期から座位、起立台(傾斜台)訓練を行う。

体温管理
頸髄損傷者では、発汗障害によるうつ熱が著明。衣服や環境に配慮する。

膀胱と尿路管理
受傷直後は排尿確保のため持続カテーテルをするが、早期に抜去しなければ尿路感染が起こる。間欠導尿が望ましい。

自律神経過剰反射
第6胸髄以上の高位脊髄損傷者に、頭痛、徐脈、発汗を伴う急激な血圧上昇が起こりやすい。

関節こう縮
慢性期のけい縮、筋力のアンバランスがあると起こりやすい。

骨粗しょう症
リハビリ中の骨接の原因となる。

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