Stroke inoratidzwa nehuwandu hwezviitiko uye huwandu hwehurema hwakanyanya.Kune vangangoita 2 miriyoni varwere vesitiroko muChina gore rega rega, avo 70% kusvika 80% havakwanise kurarama vakazvimirira nekuda kwekuremara.
Iyo yekirasi ADL kudzidziswa inosanganisa kudzoreredza kudzidziswa (motor basa kudzidziswa) uye inobhadhara kudzidziswa (senge-ruoko rumwe hunyanzvi uye zvivakwa zvinosvikika) zvekushandisa pamwe chete.Nekuvandudzwa kwehunyanzvi hwekurapa uye matekinoroji ari kusimukira, matekinoroji akawanda akaiswa pakudzidziswa kweADL.
Robhoti repamusoro rekudzoreredza nhengo yemuchina muchina unoshandiswa kubatsira kana kutsiva mamwe mabasa epamusoro evanhu mukuita mabasa otomatiki.Inogona kupa varwere vane simba repamusoro-soro, rakanangwa, uye rinodzokorora rehabilitation training.Mukusimudzira kupora kunoshanda muvarwere vesitiroko, marobhoti ekuvandudza ane mabhenefiti akakosha pane echinyakare marapirwo.
Pazasi pane yakajairika nyaya yehemiplegic murwere anoshandisa robhoti kudzidziswa:
1. Nyaya Yenyaya
Murwere Ruixx, murume, ane makore makumi matanhatu nemaviri, anobvuma nekuda kwe "mazuva gumi nematatu ehurombo hwemaoko eruboshwe".
Nhoroondo yezvokurapaMangwanani emusi waChikumi 8, murwere akanzwa kupera simba mugumbo ravo rekuruboshwe uye aisakwanisa kubata zvinhu.Masikati, dzakatanga kupera simba mugumbo rezasi rekuruboshwe uye dzaitadza kufamba, dzichiperekedzwa nechiveve chenhengo yekuruboshwe uye kutaura kusina kujeka.Vakanga vachiri kukwanisa kunzwisisa mashoko evamwe, kusaremekedza kutenderera kwechinhu, kusanzwa kutinhira kana kuti kunzverwa kwenzeve, kusarwadza kwomusoro, kurutsa kwomwoyo, kusina ziso dema syncope, pakoma kana kuti kugwinha, uye kusaita weti.Nokudaro, vakauya kudhipatimendi redu rekukurumidzira kuti vawedzere kuongororwa uye kurapwa, Dhipatimendi rekukurumidzira rinoronga kurapa Neurology yechipatara chedu ne "cerebral infarction", uye kupa Symptomatic treatment yakadai se anti platelet aggregation, lipid regulation uye plaque stabilization, kuchengetedzwa kwehuropi, kusimudzira kutenderera kweropa uye kubvisa stasis yeropa, anti free radicals, kudzvanya kweasidhi uye kudzivirira mudumbu kudzivirira Irritability ulcer, kunatsiridza kutenderera kweropa, uye kutarisa BP.Mushure mekurapwa, mamiriro emurwere akaramba akadzikama, aine urombo hwekufamba kwemakumbo ekuruboshwe.Kuti uwedzere kuvandudza kushanda kwemakumbo, zvinodikanwa kuti ubvumidzwe kune dhipatimendi rekugadzirisa kurapa kwekugadzirisa.Kubva pakatanga cerebral infarction, murwere ave akaora mwoyo, achiramba achigomera, asinganzwisisi, uye akaonekwa se "post-stroke depression" muNeurology.
2. Rehabilitation kuongorora
Seye tekinoroji nyowani yekurapa tekinoroji, rTMS inoda kutarisisa maitiro ekushanda kana ichiitwa mumakiriniki ekurapa masangano:
1)Motor basa rekuongorora: Brunnstrom kuongorora: rutivi rworuboshwe 2-1-3;Fugl Meyer's chepamusoro chemakumbo chibodzwa mapoinzi mana;Muscle tension assessment: Ruboshwe rworuboshwe tsandanyama tension yakaderera;
2)Sensory function assessment: yakadzika uye isina kudzika Hypoesthesia yeruboshwe repamusoro nhengo uye ruoko.
3)Emotional function assessment: Hamilton Depression Scale: 20 points, Hamilton Anxiety Scale: 10 points.
4)Zviito zvemazuva ese ekurarama mamakisi (yakagadziridzwa Barthel index): 28 mapoinzi, ADL yakanyanya kusashanda zvakanaka, hupenyu hunoda rubatsiro.
5)Murwere murimi nebasa uye pari zvino haakwanise kubata ruoko rwake rweruboshwe izvo zvinovatadzisa kuita mabasa ekurima.Kutandara nekutandara kwakadzikiswa zvakanyanya kubva pakatanga chirwere.
Takagadzira chirongwa chekurapa kwekugadzirisa matambudziko ekushanda kwaSekuru Rui uye zviratidzo zvekuora mwoyo, takatarisana nekuvandudza mashandiro eADL emurwere, kuratidza kufambira mberi kwaSekuru, kuwedzera kuzviziva, uye kunzwa kuti vanhu vanobatsira.
3. Rehabilitation kurapwa
1)Inducing Upper Limb Separation Movement: Kurapa kweKubatwa Kwepamusoro Limb Pushing Drum uye Functional Electrical Stimulation.
2)Kudzidziswa kwekutungamira kweADL: Nhengo yemurwere yekumusoro ine hutano inopedzisa kudzidziswa kwehunyanzvi sekupfeka, kubvisa, uye kudya.
3)Upper Limb Robhoti Kudzidzira:
Muenzaniso wemishonga unotungamirirwa nekugona kwehupenyu.Ipa hupenyu hwezuva nezuva kuita dzidziso yekudzidziswa kudzidzisa varwere 'zuva nezuva kugona kurarama (ADL)
- Kudzidzira kudya
- Combing kudzidziswa
- Ronga uye rongedza kudzidziswa
Mushure memavhiki maviri ekurapwa, murwere akakwanisa kubata mabhanana neruoko rwake rwekuruboshwe kuti adye, kunwa mvura yemukombe neruoko rwake rweruboshwe, kumonera tauro nemaoko maviri, uye kugona kwake kurarama zuva nezuva kwakavandudzika zvakanyanya.Sekuru Rui vakazosekerera.
4. Zvakanakira zvemarobhoti ekumusoro ekudzoreredza maoko pamusoro pekugadzirisa kwechinyakare zviri mune zvinotevera:
1)Kudzidzira kunogona kuseta ega ega maitiro ekufamba kwevarwere uye kuve nechokwadi kuti vanodzokorora mafambiro mukati meiyo yakatarwa, ichipa mikana yakawanda yezvakanangwa maekisesaizi mumakumbo epamusoro, izvo zvinobatsira kuuropi plastiki uye kurongeka kwekushanda mushure mekurova.
2)Kubva pakuona kweKinematics, dhizaini yebhaketi remaoko rerobhoti yekuvandudza yakavakirwa pamusimboti weKinematics yemunhu, iyo inogona kutevedzera mutemo wekufamba wenhengo dzepamusoro dzevanhu munguva chaiyo, uye varwere vanogona kuona nekutevedzera chiitiko ichi kakawanda maererano. kumamiriro avo pachavo;
3)Iyo yekumusoro nhengo yekudzoreredza robhoti system inogona kupa akasiyana mafomu eruzivo ruzivo munguva-chaiyo, ichiita iyo yakagomara uye monotonous kurovedza muviri kudzoreredza maitiro ekudzidzira kuve nyore, kunakidza, uye nyore.Panguva imwecheteyo, varwere vanogonawo kunakidzwa nekubudirira.
Nekuti iyo chaiyo yekudzidzira nharaunda yekumusoro yemakumbo rehabilitation robhoti yakafanana zvakanyanya nenyika chaiyo, hunyanzvi hwemotokari hunodzidzwa munharaunda chaiyo hunogona kushandiswa zviri nani kune chaiyoiyo nharaunda, zvichiita kuti varwere vabatane nezvinhu zvine zvakawanda zvinokurudzira zvinonzwa munzvimbo chaiyo mu. nzira yechisikigo, kuitira kuti zvive nani kuunganidza chido chevarwere uye kutora chikamu mukugadzirisa, uye kuwedzera kuvandudza kushanda kwemotokari yegumbo repamusoro padivi rehemiplegic uye kukwanisa kweMabasa ehupenyu hwezuva nezuva.
Munyori: Han Yingying, mutungamiri weboka reoccupational therapy muRehabilitation Medical Center yeJiangning Hospital yakabatana neNanjing Medical University.
Nguva yekutumira: Jun-16-2023