I-Stroke ibonakala ngezinga eliphezulu lezehlo kunye nezinga eliphezulu lokukhubazeka.Kukho malunga ne-2 yezigidi zezigulane ezitsha ze-stroke e-China minyaka yonke, apho i-70% ukuya kwi-80% ayikwazi ukuphila ngokuzimeleyo ngenxa yokukhubazeka.
Uqeqesho lwakudala lwe-ADL ludibanisa uqeqesho lokubuyisela (uqeqesho lomsebenzi wemoto) kunye noqeqesho lwembuyekezo (njengobuchule besandla esinye kunye nezixhobo ezifikelelekayo) kwisicelo esihlangeneyo.Ngokuphuhliswa kobuchwepheshe bezonyango kunye nobuchwepheshe obuvelayo, ubuninzi bobuchwephesha busetyenzisiwe ekuqeqesheni i-ADL.
Irobhothi yokuvuselela amalungu aphezulu sisixhobo somatshini esisetyenziselwa ukuncedisa okanye ukubuyisela imisebenzi ethile yamalungu aphezulu abantu ekwenzeni imisebenzi ngokuzenzekelayo.Inokubonelela ngezigulane amandla aphezulu, okujoliswe kuyo, kunye nokuphindaphinda uqeqesho lokubuyisela kwimeko yesiqhelo.Ekukhuthazeni ukubuyiswa komsebenzi kwizigulane ze-stroke, iirobhothi zokuvuselela zineenzuzo ezibalulekileyo kunyango lwendabuko.
Apha ngezantsi kukho imeko eqhelekileyo yesigulana se-hemiplegic esebenzisa uqeqesho lwerobhothi:
1. Intshayelelo yeCase
Isigulana u-Ruixx, oyindoda, oneminyaka engama-62 ubudala, uyavuma ngenxa "yeentsuku ezili-13 zomsebenzi ongalunganga welungu lasekhohlo".
Imbali yonyango:Ngentsasa ye-8 kaJuni, isigulane saziva sibuthathaka kwisigxina saso sasekhohlo kwaye sasingakwazi ukubamba izinto.Emini emaqanda, baba buthathaka kwilungu labo lasekhohlo elingezantsi yaye babengakwazi ukuhamba, bekhatshwa kukuba ndindisholo kwilungu lasekhohlo kunye nentetho engacacanga.Babesakwazi ukuwaqonda amazwi abanye, bengakukhathaleli ukujikeleza kwezinto, bengaziva ngathi tinnitus okanye ukuxilongwa kweendlebe, kungabikho ntlungu yentloko, ukugabha kwentliziyo, ukungaboni ngasonye kwamehlo amnyama, ukungaqaqadeki okanye ukuxhuzula, nokungakwazi kuzibamba komchamo.Ngoko ke, beza kwisebe lethu eliphuthumayo ukuze baxilongwe ngakumbi kunye nonyango, iSebe eliphuthumayo liceba ukunyanga i-Neurology yesibhedlele sethu "nge-cerebral infarction", kwaye unike unyango lwe-Symptomatic njenge-anti platelet aggregation, ukulawulwa kwe-lipid kunye nokuzinza kwe-plaque, ukukhuselwa kwengqondo, ukukhuthaza ukujikeleza kwegazi kunye nokususa i-stasis yegazi, i-anti free radicals, ukunyanzeliswa kwe-asidi kunye nokukhuselwa kwesisu ukunqanda i-Irritability ulcer, ukuphucula ukujikeleza kwegazi, kunye nokujonga uxinzelelo lwegazi.Emva konyango, imeko yesigulane yahlala izinzile, kunye nokungahambi kakuhle kwemilenze yasekhohlo.Ukuze kuphuculwe ngakumbi ukusebenza kwelungu, kufuneka ukuba wamkelwe kwisebe lokubuyisela kwimeko yonyango lokubuyisela.Ukususela ekuqaleni kwe-cerebral infarction, isigulane siye sadakumba, sincwina ngokuphindaphindiweyo, sinyanzeliswa, kwaye sixilongwa njenge "post-stroke depression" kwi-Neurology.
2. Uvavanyo lokubuyisela kwisimo sangaphambili
Njengetekhnoloji entsha yonyango lweklinikhi, i-rTMS kufuneka ithathele ingqalelo imilinganiselo yokusebenza xa isenziwa kumaziko ezonyango:
1)Uvavanyo lomsebenzi weMoto: Uvavanyo lweBrunnstrom: icala lasekhohlo 2-1-3;Amanqaku aphezulu kaFugl Meyer ngamanqaku ama-4;Uvavanyo lwe-muscle tension: Ukunyanzeliswa kwemisipha yemilenze yasekhohlo yehla;
2)Uvavanyo lomsebenzi woluvo: ubunzulu kunye nobunzulu I-Hypoesthesia yelungu eliphezulu lasekhohlo kunye nesandla.
3)Uvavanyo lomsebenzi womzwelo: I-Hamilton yokuDakumba kweScale: amanqaku angama-20, i-Hamilton Anxiety Scale: amanqaku e-10.
4)Imisebenzi yamanqaku obomi bemihla ngemihla (isalathisi seBarthel esilungisiweyo): amanqaku angama-28, ukungasebenzi kakuhle kwe-ADL, ubomi bufuna uncedo
5)Isigulana singumlimi ngokomsebenzi kwaye okwangoku asikwazi ukubamba ngesandla sasekhohlo, nto leyo ethintela imisebenzi yabo yesiqhelo yokulima.Imisebenzi yokuzonwabisa kunye nokuzonwabisa ithintelwe kakhulu ukususela ekuqaleni kokugula.
Siye saqulunqa isicwangciso sonyango lokubuyisela kwimeko yesiqhelo kwiingxaki zokusebenza kukaTatomkhulu uRui kunye neempawu zokudakumba, sijolise ekuphuculeni ukusebenza kwe-ADL yesigulana, ukubonakalisa inkqubela kaTatomkhulu, ukukhulisa ukuzazi, kunye nokuziva ukuba ungabantu abaluncedo.
3. Unyango lokubuyisela kwisimo sangaphambili
1)Ukunyanzeliswa kweNtshukumo yoKwahlula iLimb ePhezulu: Unyango lweGugu eliNgxamisekileyo loKutyhala iLungu eliPhezulu kunye nokuVuselelwa koMbane okuSebenzayo.
2)Uqeqesho lwesikhokelo se-ADL: Ilungu eliphezulu lesigulana elisempilweni ligqibezela uqeqesho lwezakhono ezinjengokunxiba, ukukhulula, nokutya.
3)Uqeqesho lwerobhothi yelungu eliphezulu:
Imodeli yommiselo ekhokelwa bubuchule bobomi.Ukubonelela ngoqeqesho lonyango lwemihla ngemihla ukuze kuqeqeshwe izigulana ezikwazi ukuphila mihla le (ADL)
- Uqeqesho lokutya
- Uqeqesho lokukama
- Lungiselela kwaye uhlele uqeqesho
Emva kweeveki ezimbini zonyango, isigulana sasikwazi ukuhlutha iibhanana ngesandla sasekhohlo ukuze sitye, ukusela amanzi ekomini ngesandla sasekhohlo, ukujija itawuli ngezandla zozibini, kwaye amandla akhe okuphila kwemihla ngemihla aphucula kakhulu.Ekugqibeleni uTatomkhulu uRui wancuma.
4. Izinto eziluncedo kwiirobhothi zokubuyisela kwisimo sangaphambili ngaphezu kokubuyisela kwisimo sangaphambili kule miba ilandelayo:
1)Uqeqesho lunokumisela iipatheni zokushukuma komntu kwizigulane kwaye ziqinisekise ukuba ziphindaphinda ukunyakaza ngaphakathi koluhlu olumiselweyo, ukubonelela ngamathuba amaninzi okuzivocavoca okujoliswe kuyo kwimilenze ephezulu, enenzuzo kwiplastiki yengqondo kunye nokuhlengahlengiswa komsebenzi emva kokubetha.
2)Ngokombono we-Kinematics, ukuyila kwe-arm bracket ye-robot yokubuyisela isekelwe kumgaqo-siseko we-Kinematics yabantu, onokulinganisa umthetho wokuhamba kwamalungu aphezulu omntu ngexesha langempela, kwaye izigulane zinokujonga kwaye zixelise umsebenzi ngokuphindaphindiweyo ngokutsho. kwiimeko zabo;
3)Inkqubo yerobhothi yokuvuselela amalungu aphezulu inokubonelela ngeendlela ezahlukeneyo zolwazi lwengxelo ngexesha lokwenyani, yenze inkqubo yoqeqesho yokubuyisela kwisimo sangaphambili ilula, inomdla kwaye ilula.Kwangaxeshanye, izigulana zinokunandipha impumelelo.
Ngenxa yokuba indawo yoqeqesho oluyinyani yerobhothi yokuvuselela amalungu aphezulu ifana kakhulu nehlabathi lokwenyani, izakhono zemoto ezifundwe kwindawo ebonakalayo zinokusetyenziswa ngcono kwindawo eyiyo, ikhuthaza izigulana ukuba zinxibelelane nezinto ezinezivuseleli zoluvo ezininzi kwindawo enenyani. indlela yendalo, ukuze kuhlanganiswe ngcono umdlandla wezigulane kunye nokuthatha inxaxheba ekubuyiseleni kwimeko yesiqhelo, kunye nokuphucula ngakumbi umsebenzi wemoto welungu eliphezulu kwicala le-hemiplegic kunye nokukwazi kweMisebenzi yemihla ngemihla.
Umbhali: uHan Yingying, inkokeli yeqela lonyango lomsebenzi kwiZiko lezoNyango lokuBuyiselwa kweSibhedlele saseJiangning esidityaniswe neYunivesithi yezoNyango yaseNanjing
Ixesha lokuposa: Jun-16-2023