精品周围神经病损的康复课件_1

周围神经病损的康复 概述 1.周围神经：是由脑和脊髓以外的神经节 、神经丛、神经干及神经末梢组成。是 由运动纤维、感觉纤维和自主神经纤维 组成的混合神经。 概述 2.分类： (1)神经痛：感觉神经分布区发生剧痛，而神经 传导功能正常。 (2)神经病： 神经炎：由于炎症、中毒、营养缺乏、代谢障 碍、外伤等引起的病变，称为神经炎。 周围神经损伤：周围神经丛、神经干或其分支 受外力作用而发生损伤，称为周围神经损伤。 又分为神经功能失用、轴索断裂、神经断裂。 概述 3.临床表现：运动障碍、感觉障碍、反 射障碍、自主神经功能障碍。 康复评定 1肌力测定：徒手肌力和器械检查 2肌腱反射检查： 3患肢周径的测量 4关节活动范围的测量 5感觉检查 康复评定 6出汗试验 7电生理学检查：直流感应电测定、强 度-时间曲线检查、神经肌肉电图检查、 神经传导速度测定 8日常生活活动能力的测定 9家庭、职业等社会环境的调查 10生活满意度的调查 康复治疗 1预防与治疗并发症 （1）浮肿：抬高患肢、绷带压迫、向心 性按摩、被动活动、冷敷、高频电疗等 （2）软组织挛缩和骨骼畸形：早期被动 活动、必要时夹板固定功能位 （3）继发性外伤： 康复治疗 2促进神经再生：必要的话修补、理疗 、药物 3保持肌肉质量、迎接神经的再支配 康复治疗 4增强肌力，促进运动功能的恢复： 1级：辅助运动 2-3级：辅助运动、主动运动、器械运动 3-4级：抗阻运动 结合日常生活功能性训练 作业疗法 康复治疗 5促进感觉神经的恢复 6患者注意的问题 避免代偿动作 防止皮肤损害 禁忌过伸动作 避免过度疲劳 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