護理師照護一位脊髓損傷病人，哪種損傷程度與自主神經反射異常（Autonomic dysreflexia）風險最高？

自主神經反射異常（Autonomic dysreflexia, AD）是一種發生在脊髓損傷（Spinal cord injury, SCI）病人的急性、致命性緊急狀況。其核心機制在於脊髓損傷平面以下的有害刺激（最常見為膀胱脹滿或腸道嵌塞）引發交感神經劇烈反應，但因損傷阻斷了上行抑制訊號，導致血管劇烈收縮，引發高血壓危象。AD 通常發生在 T6 或以上的損傷，因為此平面以上的交感神經流出受損，導致無法進行全身性的代償調節。臨床護理首重移除刺激源並監測血壓。

Autonomic dysreflexia (AD) is an acute, life-threatening emergency that occurs in patients with spinal cord injury (SCI). Its core mechanism is a noxious stimulus below the level of the injury (most commonly a distended bladder or fecal impaction) triggering an intense sympathetic response; because the injury blocks descending inhibitory signals, this produces severe vasoconstriction and a hypertensive crisis. AD typically occurs in injuries at T6 or above, because lesions at this level disrupt sympathetic outflow and prevent systemic compensatory regulation. The clinical nursing focus is to remove the triggering stimulus and to monitor the blood pressure.