系統性紅斑性狼瘡伴隨橫斷性脊髓炎之物理治療：病例報告

「系統性紅斑性狼瘡」(systemic lupus erythematosus, SLE)屬於人體自體免疫性疾病中的一種，好發於年輕女性，此病會侵犯多個組織器官，其中最常侵犯的包括皮膚、關節、腎臟、中樞神經系統、漿膜層和血液的成分等。「橫斷性脊髓炎」(transverse myelitis, TM)為影響脊髓的一種症候群，由於某些原因而造成脊髓發炎的現象，進而造成動作、感覺，甚至括約肌控制的損害，然而，會引起這種病徵的紅斑性狼瘡患者並不常見。本個案是一名56歲的女性病患，臨床表現包括四肢肢體麻(numbness)、感覺異常(paresthesia)、半身癱瘓和大、小便失禁的問題。依據其臨床症狀、免疫學、血液學以及神經學檢查，診斷為系統性紅斑性狼瘡伴隨腦、脊髓和周邊神經病變，其橫斷性脊髓炎的問題極為明顯。經過近一個半月的物理治療後，其上肢肌力平均各增進一分，轉位等功能能力也有大幅改善。本文主要是針對系統性紅斑性狼瘡和其引發的橫斷性脊髓炎作一簡介，並對其物理治療的介入作一說明。

關鍵字

系統性紅斑性狼瘡；橫斷性脊髓炎；物理治療

並列摘要

Systemic lupus erythematosus (SLE) is a human autoimmune disorder. It often appears in young women and affects many body systems, such as skin, joints, kidney, central nervous system, serous membranes, and blood elements. Transverse myelitis (TM) is defined as a syndrome which affects the spinal cord and involves inflammation. It may result in impairments of motor, sensory, and sphincter control. TM is rare in patients with SLE. The reported case in this study was a 56-year-old female patient. Her clinical manifestations included numbness, paresthesia, paraplegia, and incontinence. According to these clinical presentations, immunological study, hematological findings, and neurological examinations, she was diagnosed as a case of SLE with encephalomyeloradiculopathy and TM. After intensive physical therapy, her muscle strength of upper extremities showed one grade improvement, and the ability of transfer was also improved. In addition to discuss SLE and related TM, we share our experience in the physical therapy evaluation and management.

並列關鍵字

Systemic lupus erythematosus ； Transverse myelitis ； Physical therapy

國際替代計量

系統性紅斑性狼瘡伴隨橫斷性脊髓炎之物理治療：病例報告

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