目的:了解ICU病房地震伤员的功能障碍的特点,为临床康复治疗提供依据。方法:运动功能评定应用MMT方法;运用关节角度尺评定关节活动度(ROM);利用被动关节活动法评定肌张力、痉挛评定选用改良的Ashworth分级法;坐位平衡和站位平衡采用平衡反应试验评定;日常生活活动(ADL)能力选用国际通用的Barthel指数量表评定。由我科研究生作为评定人员。结果:①ICU病房地震伤员以骨折患者为主,占70%,神经系统损伤占20%,挤压综合症和肺挫伤各占5%;②女性骨折比例高于男性,为11∶3;神经系统损伤没有多大差异;截肢和瘫痪的患者中,男性高于女性,比例分别为4∶1和3∶2;肺部感染以女性更为明显,为7∶1;③47.6%的地震伤员关节活动受限(评定21人),93.3%的肌力下降(评定15人),15.8%肌张力下降(评定19人),36.8%肌张力增高(评定19人),30.0%的坐位平衡下降(评定10人),96.4%站立平衡下降;④ADL能力100%受限(评定20人),其中洗澡、修饰、如厕、平地行走45 m、上下楼梯受限均为100%,95%地震伤员进食能力下降,90%穿衣能力受限,35%大便失禁,60%小便控制能力下降,多数使用导尿管,95%地震伤员床椅转移能力下降;⑤40%出现肺部感染。结论:关节活动度受限、肌力下降、肌张力异常、平衡功能障碍、ADL能力受限及肺部感染是ICU地震伤员主要功能障碍。早期康复介入、维持和改善关节活动度、肌力训练、减张和牵伸训练、平衡训练、呼吸训练、站立和行走训练及ADL能力训练应当作为康复治疗的基本原则和方法。
Citation:
ZHANG Jinlong,LIN Handan,KANG Yan,et al. The Motor Function and Activity of Daily Living of the Injured in 5·12 Wenchuan Earthquake. West China Medical Journal, 2009, 24(3): 547-549. doi:
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MULVEY J M, AWAN S U, QADRI A A, et al. Profile of injuries arising from the 2005 Kashmir earthquake: The first 72 h[J]. Injury,2008,39:554-560..
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ROY N, SHAH H, PATEL V, et al. Surgical and psychosocial outcomes in the rural injureda followup study of the 2001 earthquake victims[J]. Injury,2005,36 (8):927934..
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EMAMI M J, TAVAKOLI A R, ALEMZADEH H, et al. Strategies in evaluation and management of Bam earthquake victims[J]. Prehosp Disaster Med,2005,20 (5):327-330.
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- 1. MULVEY J M, AWAN S U, QADRI A A, et al. Profile of injuries arising from the 2005 Kashmir earthquake: The first 72 h[J]. Injury,2008,39:554-560..
- 2. ROY N, SHAH H, PATEL V, et al. Surgical and psychosocial outcomes in the rural injureda followup study of the 2001 earthquake victims[J]. Injury,2005,36 (8):927934..
- 3. EMAMI M J, TAVAKOLI A R, ALEMZADEH H, et al. Strategies in evaluation and management of Bam earthquake victims[J]. Prehosp Disaster Med,2005,20 (5):327-330.