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一位個案最近移除硬脊膜外導管並恢復使用 apixaban。檢視趨勢並選擇最佳的解釋和措施。

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Time	Data
0900	Epidural catheter removed; leg strength is equal; no back pain; bladder function is normal移除硬脊膜外導管；腿部力量相等；無背痛；膀胱功能正常
1700	Apixaban resumed according to the authorized plan; mild local soreness only根據核准計畫恢復使用 apixaban；僅有輕微局部疼痛
2300	Severe midline back pain; progressive bilateral leg weakness; difficulty initiating urination嚴重中線背痛；進行性雙側腿部無力；排尿困難

Q1. Which complication is most concerning?哪種併發症最令人擔憂？

Expected catheter-site soreness預期的導管部位疼痛 Spinal or epidural hematoma with neurologic compromise脊髓或硬脊膜外血腫伴神經功能受損 Delayed uncomplicated muscle strain延遲性無併發症的肌肉拉傷

Q2. Which action is the priority?哪項措施是優先的？

Urgently notify the authorized team and activate neurologic and procedural evaluation緊急通知授權團隊並啟動神經學和程序評估 Give the next anticoagulant dose and reassess next shift給予下一劑抗凝血劑並在下一班次重新評估 Encourage walking to relieve the back pain鼓勵行走以緩解背痛

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