脊髓损害的评定办法、病因和临床表现
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓<span style="color: black;">损害</span>是<span style="color: black;">因为</span><span style="color: black;">各样</span>不同<strong style="color: blue;">致病<span style="color: black;">原因</span></strong><span style="color: black;">导致</span>的脊髓结构、功能的损害，造<span style="color: black;">成为了</span><span style="color: black;">损害</span>水平以下正常运动、感觉、自主功能的改变。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q0.itc.cn/q_70/images01/20240125/afb832e6f8cf4b8c98200cb11fe07506.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">脊髓<span style="color: black;">损害</span>的临床<span style="color: black;">评定</span><span style="color: black;">办法</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓<span style="color: black;">损害</span>程度可用ASIA分级来<span style="color: black;">评定</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A：完全性损害：再骶段(S4-5)，<span style="color: black;">没</span>任何感觉、运动功能<span style="color: black;">保存</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B：不完全性损害：在神经平面以下<span style="color: black;">包含</span>骶段(S4-5)存在感觉功能，但<span style="color: black;">没</span>运动功能。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C：不完全性损害：在神经平面以下存在运动功能，大部分肌的肌力<span style="color: black;">少于</span>3级。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D：不完全性<span style="color: black;">损害</span>：在神经平面以下存在运动功能，大部分肌的肌力大于或等于3级。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">E：正常：感觉和运动功能正常。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">骶部感觉</strong><span style="color: black;">指的是</span>肛门粘膜皮肤交界处的轻触觉和针刺觉及肛门内部深压觉;<strong style="color: blue;">骶部运动功能</strong><span style="color: black;">指的是</span><span style="color: black;">经过</span>肛门指检<span style="color: black;">检测</span>肛门外括约肌有<span style="color: black;">没</span>自主收缩。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">脊髓<span style="color: black;">损害</span>的病因</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓<span style="color: black;">损害</span>分为<strong style="color: blue;">外伤性和非外伤性</strong>脊髓<span style="color: black;">损害</span>(炎症、肿瘤)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 外伤性脊髓<span style="color: black;">损害</span>：</strong><span style="color: black;">平常</span>的有车祸、高空坠落、运动<span style="color: black;">损害</span>、意外暴力等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">非外伤性：</strong>脊髓炎、肿瘤、血管破裂、脊髓前动脉血栓等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓<span style="color: black;">损害</span>以青壮年为主，年龄年龄在<strong style="color: blue;">40岁以下者约占80%</strong>，男性多见。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">脊髓<span style="color: black;">损害</span>的临床表现</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 1、感觉<span style="color: black;">阻碍</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">显现</span>脊髓<span style="color: black;">损害</span>时，<span style="color: black;">损害</span>平面以下躯干、四肢感觉<span style="color: black;">衰退</span>或消失，<span style="color: black;">无</span>触觉、痛觉等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 2、运动<span style="color: black;">阻碍</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">患病后肌肉、肌力<span style="color: black;">逐步</span>降低，常伴运动<span style="color: black;">阻碍</span>。如颈段脊髓<span style="color: black;">损害</span>时，四肢功能<span style="color: black;">显现</span>问题，可能有四肢瘫痪表现;胸段、腰段、骶尾段<span style="color: black;">损害</span>时，下肢会瘫痪。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 3、反射<span style="color: black;">阻碍</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓掌控身体反射系统，<span style="color: black;">显现</span>脊髓<span style="color: black;">损害</span>后，反射系统受影响，常有反射减弱或消失。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 4、二便<span style="color: black;">阻碍</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓<span style="color: black;">损害</span>可影响<span style="color: black;">体积</span>便，可能有尿潴留、<span style="color: black;">体积</span>便失禁、排便困难等表现。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> 5、体温调节<span style="color: black;">阻碍</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">显现</span>脊髓<span style="color: black;">损害</span>后，体温调节<span style="color: black;">显现</span><span style="color: black;">反常</span>，有些<span style="color: black;">病人</span><span style="color: black;">显现</span>高烧不退表现。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">怎样</span><span style="color: black;">恢复</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"> <span style="color: black;">恢复</span>训练原则</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、<span style="color: black;">初期</span><span style="color: black;">起始</span>神经系统功能下降，肌肉萎缩，骨质疏松，关节活动度因瘫痪日久而<span style="color: black;">逐步</span>下降。功能<span style="color: black;">熬炼</span>愈早<span style="color: black;">起始</span>愈易恢复，愈晚进行则功能恢复所需的时间愈长。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、循序渐进，从易到难。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、从功能<span style="color: black;">必须</span>进行<span style="color: black;">熬炼</span>，达到恢复该功能的目的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4、力量与耐力训练肌肉力量的增长是渐进的，<span style="color: black;">仅有</span><span style="color: black;">保持</span>不懈的<span style="color: black;">熬炼</span>，<span style="color: black;">才可</span><span style="color: black;">逐步</span><span style="color: black;">加强</span>。达到<span style="color: black;">必定</span>力量之后，<span style="color: black;">才可</span>完成某项功能<span style="color: black;">需求</span>的动作。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">我是<span style="color: black;">恢复</span>科郑琳，云南省<span style="color: black;">恢复</span>医学会儿童<span style="color: black;">生长</span>与<span style="color: black;">恢复</span>专业委员会副<span style="color: black;">专家</span>委员、中国残疾人<span style="color: black;">恢复</span>协会小儿脑瘫<span style="color: black;">恢复</span>专业委员会委员等。从事临床医疗工作30余年。专业<span style="color: black;">善于</span>偏瘫<span style="color: black;">恢复</span>、脊髓<span style="color: black;">损害</span><span style="color: black;">恢复</span>、脑瘫<span style="color: black;">恢复</span>、<span style="color: black;">周边</span>神经<span style="color: black;">损害</span><span style="color: black;">恢复</span>。</p>
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