四肢／脊椎骨折與急性肌少症

Extremity / Spine Fractures and Acute Sarcopenia

10.6320/FJM.202307_27(4).0010

楊宗翰(Tsung-Han Yang)；陳宣佑(Hsuan-Yu Chen)；楊榮森(Rong-Sen Yang)

急性肌少症 ； 骨折 ； 肌肉損傷 ； 脊髓損傷 ； acute sarcopenia ； fracture ； muscle injury ； spinal cord injury

台灣醫學

27卷4期（2023 / 07 / 25）

474 - 478

繁體中文;英文

發生急性四肢或脊椎骨折時，短時間內即會對病人肌肉造成重大影響，骨折或肌肉創傷會直接或間接造成肌肉傷害，例如骨折石膏固定限制肢體活動，或因手術和住院治療，活動量減少，加上發炎和營養不良，僅短短住院兩週，肌肉就有可能快速流失，體重減輕，即為急性肌少症，在年輕人身上也可導致嚴重後果。當病況嚴重而需加護病房或長期住院時，肌少症情況會更嚴重，日後繼續影響病人生理機能和生活品質，應及早防治。本文討論臨床上骨折創傷所引起的急性肌少症，包括病因、發生率、病理機制等，並提供防治建議。

Acute fractures of extremities and spine have a significant impact on the patient's muscles within a short period of time. Fracture or muscle trauma directly cause serious damage to the muscles. It may also possibly come from by indirect factors, e.g., using a cast for immobilization of the fracture fragment and restricting limb mobility. Surgeries and hospitalization also restrict patient's activities, in addition to inflammation and malnutrition. Significant and rapid muscle and weight loss may occur soon within two weeks of hospitalization. All these situations are acute sarcopenia. Young patients also have severe consequences after such insults. Serious conditions need intensive care for a long time and may incur severe acute sarcopenia and affect their long-term prognosis, physiological function and quality of life as well. It merits early prevention and treatment as soon as possible. This article discusses the etiology, incidence and pathological mechanism, etc. of fracture-related acute sarcopenia in clinical practice. The suggestions for prevention and treatment will also be presented.