I-Stroke ibonakala ngezinga eliphezulu lezehlakalo nezinga eliphezulu lokukhubazeka.Kuneziguli ezintsha ezicishe zibe yizigidi ezi-2 e-China minyaka yonke, lapho u-70% kuya ku-80% engakwazi ukuphila ngokuzimela ngenxa yokukhubazeka.
Ukuqeqeshwa kwe-ADL kwakudala kuhlanganisa ukuqeqeshwa okubuyisela esimweni (ukuqeqeshwa kokusebenza kwemoto) nokuqeqeshwa okuyisinxephezelo (njengamasu okwenziwa ngesandla esisodwa kanye nezindawo ezifinyeleleka kalula) ukuze kusetshenziswe ngokuhlanganyela.Ngokuthuthukiswa kobuchwepheshe bezokwelapha kanye nobuchwepheshe obusafufusa, kusetshenziswe ubuchwepheshe obuningi ekuqeqeshweni kwe-ADL.
Irobhothi elingaphezulu lokuvuselela isitho somzimba liwumshini osetshenziselwa ukusiza noma ukushintsha imisebenzi ethile yangaphezulu yabantu ekwenzeni imisebenzi ngokuzenzakalelayo.Inganikeza iziguli ukuqeqeshwa kokuvuselela okunamandla, okuhlosiwe, nokuphindaphindayo.Ekukhuthazeni ukululama kokusebenza ezigulini zohlangothi, amarobhothi okuvuselela anezinzuzo ezibalulekile ngaphezu kokwelashwa kwendabuko.
Ngezansi kunesimo esijwayelekile sesiguli se-hemiplegic sisebenzisa ukuqeqeshwa kwerobhothi:
1. Isingeniso Secala
Isiguli u-Ruixx, owesilisa, oneminyaka engama-62 ubudala, uyavuma ngenxa “yezinsuku eziyi-13 zokungasebenzi kahle kwesitho sobunxele”.
Umlando wezokwelapha:Ekuseni ngoJuni 8, isiguli sazizwa sibuthakathaka esithweni saso sangakwesokunxele futhi sasingakwazi ukubamba izinto.Emini, baqala ukuba buthakathaka esithweni sabo esingezansi kwesokunxele futhi bengakwazi ukuhamba, okuhambisana nokuba ndikindiki esithweni sangakwesokunxele kanye nenkulumo engacacile.Babesakwazi ukuqonda amazwi abanye, ukunganaki ukuzungezisa izinto, ukukhala kwendlebe noma ukuhlolwa kwezindlebe, ukungabi nabuhlungu kwekhanda, ukuhlanza kwenhliziyo, ukungaboni ngasolinye kwamehlo amnyama, ukukoma noma ukudlikizeka, nokungakwazi ukuzibamba umchamo.Ngakho-ke, beza emnyangweni wethu ophuthumayo ukuze bathole ukuxilongwa okwengeziwe nokwelashwa, Umnyango wezimo eziphuthumayo uhlela ukwelapha i-Neurology yesibhedlela sethu "nge-cerebral infarction", futhi unikeze ukwelashwa kwe-Symptomatic njenge-anti platelet aggregation, ukulawulwa kwe-lipid kanye nokuqiniswa kwe-plaque, ukuvikelwa kobuchopho, ukukhuthaza ukujikeleza kwegazi nokususa ukuqina kwegazi, ama-anti free radicals, ukucindezelwa kwe-asidi nokuvikelwa kwesisu ukuvimbela izilonda ezicasulayo, ukuthuthukisa ukujikeleza kwegazi okuhlangene, nokuqapha umfutho wegazi.Ngemva kokwelashwa, isimo sesiguli sahlala sizinzile, nokunganyakazi kahle kwezitho zesobunxele.Ukuze uqhubeke nokwenza ngcono ukusebenza kwezitho zomzimba, kuyadingeka ukuthi ungeniswe emnyangweni wokubuyisela ukuze uthole ukwelashwa kokubuyisela.Kusukela ekuqaleni kwe-cerebral infarction, isiguli siye sacindezeleka, sibubula ngokuphindaphindiwe, singenzi lutho, futhi sitholakala ngokuthi "ukucindezeleka kwangemva kokushaywa unhlangothi" ku-Neurology.
2. Ukuhlolwa kokuvuselelwa
Njengobuchwepheshe obusha bokwelashwa komtholampilo, i-rTMS idinga ukunaka izinkambiso zokusebenza lapho zenziwa ezikhungweni zezokwelapha zomtholampilo:
1)Ukuhlolwa komsebenzi wezimoto: Ukuhlola kwe-Brunnstrom: uhlangothi lwesobunxele 2-1-3;Amaphuzu aphezulu kaFugl Meyer angamaphuzu ama-4;Ukuhlolwa kokuqina kwemisipha: Ukungezwani kwemisipha yesitho sesobunxele kwehlile;
2)Ukuhlolwa kokusebenza kwezinzwa: I-Hypoesthesia ejulile futhi engajulile yengalo engenhla yesobunxele nesandla.
3)Ukuhlolwa kokusebenza kwemizwelo: I-Hamilton Depression Scale: amaphuzu angu-20, I-Hamilton Anxiety Scale: amaphuzu angu-10.
4)Imisebenzi yamaphuzu okuphila kwansuku zonke (inkomba ye-Barthel eguquliwe): amaphuzu angama-28, ukungasebenzi kahle kwe-ADL, impilo idinga usizo
5)Isiguli singumlimi ngokomsebenzi futhi okwamanje asikwazi ukubamba ngesandla sobunxele, okuphazamisa imisebenzi yaso evamile yokulima.Imisebenzi yezokungcebeleka neyokuzijabulisa ibikhawulelwe kakhulu kusukela kwaqala ukugula.
Senze uhlelo lokwelapha lokuhlunyeleliswa kwezimilo zezinkinga zokusebenza kukaMkhulu uRui kanye nezimpawu zokucindezeleka, ngokugxila ekuthuthukiseni ukusebenza kwe-ADL yesiguli, ukukhombisa inqubekelaphambili kaBabamkhulu, ukuthuthukisa ukuzazi, kanye nomuzwa wokuthi ungabantu abawusizo.
3. Ukwelashwa kokuvuselela
1)Ukuyenga Ukunyakaza Kokuhlukaniswa Kwezitho Ezingenhla: Ukwelashwa Kwesigubhu Sokusunduza Esingenhla Esithintekile kanye Nokuvuselela Ugesi Okusebenzayo
2)Ukuqeqeshwa kokuqondisa kwe-ADL: Isitho esiphezulu esinempilo sesiguli siqedela ukuqeqeshwa kokuqondisa kwamakhono njengokugqoka, ukukhumula, nokudla.
3)Ukuqeqeshwa kwerobhothi lesitho esiphezulu:
Imodeli kadokotela eqondiswa amandla empilo.Nikeza ukuqeqeshwa kwemithi yempilo yansuku zonke ukuze uqeqeshe ikhono lokuphila nsuku zonke leziguli (ADL)
- Ukuqeqeshwa kokudla
- Ukuqeqeshwa kokukama
- Hlela futhi uhlukanise ukuqeqeshwa
Ngemva kwamasonto amabili sokwelashwa, isiguli sakwazi ukubamba ubhanana ngesandla sobunxele ukuze sidle, saphuza amanzi enkomishini yaso kwesokunxele, sasonta ithawula ngezandla zombili, futhi ikhono laso lokuphila nsuku zonke laba ngcono kakhulu.Ekugcineni umkhulu uRui wamamatheka.
4. Ubuhle bamarobhothi angaphezulu okuvuselela isitho somzimba ngaphezu kokuvuselelwa ngokwesiko ilele kulezi zici ezilandelayo:
1)Ukuqeqeshwa kungasetha amaphethini okunyakaza komuntu siqu ezigulini futhi kuqinisekise ukuthi ziphinda ukunyakaza ngaphakathi kwebanga elimisiwe, okuhlinzeka ngamathuba amaningi okuzivocavoca okuhlosiwe emilenzeni ephezulu, okuzuzisa ipulasitiki yobuchopho nokuhlelwa kabusha kokusebenza ngemva kokushaywa unhlangothi.
2)Ngokombono we-Kinematics, ukuklanywa kwe-arm bracket ye-robot yokuvuselela kusekelwe esimisweni se-Kinematics yomuntu, esingalingisa umthetho wokunyakaza wezitho ezingenhla zomuntu ngesikhathi sangempela, futhi iziguli zingakwazi ukubona futhi zilingise umsebenzi ngokuphindaphindiwe ngokusho ezimeni zabo;
3)Isistimu yerobhothi yokuvuselela izitho zangaphezulu ingahlinzeka ngezindlela ezahlukahlukene zolwazi lwempendulo ngesikhathi sangempela, yenze inqubo yokuqeqeshwa kokuvuselela umsebenzi oyisiphukuphuku noyisidina ibe lula, ithakazelise, futhi ibe lula.Ngesikhathi esifanayo, iziguli nazo zingajabulela impumelelo.
Ngenxa yokuthi indawo yokuqeqeshwa ebonakalayo yerobhothi eliphezulu lokuvuselela imilenze ifana kakhulu nomhlaba wangempela, amakhono emoto afundwa endaweni ebonakalayo angasetshenziswa kangcono endaweni yangempela, okwenza iziguli zihlanganyele nezinto ezinezinzwa eziningi ezithinta izinzwa endaweni ebonakalayo indlela engokwemvelo, ukuze kuhlanganiswe kangcono umdlandla weziguli nokubamba iqhaza ekuvuseleleni, futhi kuthuthukiswe ukusebenza kwemoto yesitho esingenhla ohlangothini lwe-hemiplegic kanye nekhono Lemisebenzi yokuphila kwansuku zonke.
Umbhali: U-Han Yingying, umholi weqembu lezokwelapha emsebenzini e-Rehabilitation Medical Center yase-Jiangning Hospital exhumene ne-Nanjing Medical University
Isikhathi sokuthumela: Jun-16-2023