Polio is an acute disease caused by poliovirus. There are three types of viruses, namely, types 1, 2 and 3. The incubation period is from five to thirty-five days, but usually it is seven to fourteen days, especially in cases with paralysis symptoms. Patients may have mild symptoms such as fever, headache, sore throat, vomiting, diarrhea or constipation. A small number will have muscle pain, and muscle weakness in limbs and face. Breathing and eating functions may be affected, which may be life-threatening. Polio, commonly known as polio, is caused by poliovirus. The virus is mainly spread by food pollution or droplets, and the damage site is the motor neurons (lower motor neurons) in the anterior horn of the spinal cord. It is characterized by paralysis after 3-4 days of fever before paralysis or after hypothermia, which can be spinal cord type, medullary type, encephalitis type or mixed type. After 1-2 weeks, the sick muscles recover, or form persistent paralysis. < P > Generally speaking, disability is more common than death. The results are different due to different symptoms (paralysis or no paralysis) and affected parts. In more than 9% of cases, the brain and spinal cord are not affected, so most of them can recover completely.
how is polio spread?
Polio is mainly caused by the spread of virus through feces. It can also be spread through food and milk contaminated by feces. There is no evidence that diseases can be transmitted by insects.
how to prevent polio?
tourists should complete vaccination before departure. Polio vaccine can protect most people from infection (more than 9% effective). Vaccines are divided into oral and injection. Vaccination should be started in infancy. Basically, you should receive three doses, preferably four doses (more doses may be needed in areas where the disease is prevalent). Tourists should consult a family doctor if they have not completed the evacuation procedure. During travel, if you suspect that food (including milk products) has been contaminated, you must avoid eating it.
how to treat polio?
The main purpose of treatment is to control the symptoms, so as to make the infection subside naturally. Symptomatic treatments include painkillers, physical therapy, braces and orthopedic shoes, and even surgery to promote the rehabilitation of muscle function. When the illness is serious, you may need to rely on assistive devices to breathe to ensure your life.
How is the disability of polio sequela formed
How is the disability of polio sequela formed
At the early stage of the disease, children with polio have muscle atrophy and limb paralysis, but the paralyzed limbs are not deformed, but with the extension of the course of disease, various deformities gradually appear. The main reasons are as follows: ① Part of the muscles that dominate the limbs are paralyzed, resulting in the imbalance of strength between different muscles. For example, the muscles that dominate the varus are paralyzed, but the muscles that dominate the varus are not paralyzed, resulting in an imbalance of strength on both sides of the foot, a strong medial side and a weak lateral side, and varus will occur. ② Soft tissue contracture around the affected limb joint, resulting in deformity. For example, the soft tissue contracture behind the knee joint will cause the deformity of knee joint flexion and extension. ③ Abnormal walking and other weight-bearing activities aggravate deformity. For example, the above-mentioned deformity of muscle imbalance or soft tissue contracture can be corrected in the early stage, but the patient does not understand this, but continues to walk or do other activities in an abnormal posture, which will aggravate the deformity; On the contrary, if the limb is fixed in the posture of a healthy person with splint, the occurrence of deformity can be prevented. ④ The disuse and inactivity of limbs is another important cause of deformity. After the onset, the children's limbs are paralyzed and inactive, and the growth and development of limbs are closely related to the normal physiological activities of the human body. As a result, the bones, muscles and other soft tissues of the affected limbs develop slowly or even degenerate, resulting in short, thin limbs, joint relaxation and even dislocation. ⑤ The maintenance of long-term bad posture is another important factor of limb deformity. For example, sitting cross-legged for a long time after paralysis will cause deformity of hip and knee joint flexion and extension. Long-term bending posture with chest and waist not straight will cause spinal bending deformity.
In addition, the long-term paralysis of children leads to limb disability and deformity, the main reasons are as follows:
1. Unbalanced muscle strength: normal limbs, extensor and flexor muscles in one part, adductor and abductor muscles, varus and valgus muscles are in a state of confrontation and balance. When a certain part and a certain group of muscles are paralyzed, but the muscle strength of the opposing group is normal, the physiological balance is destroyed. At the initial stage, with the one-way movement and contraction of muscles, soft tissues such as muscles, fascia and joint capsules atrophy over time, and further develop into deformities of bones and joints.
2。 Degeneration of muscle and fascia: due to long-term paralysis of muscle, muscle degeneration, fascia thickening and contracture lead to limb deformity.
3. Abnormal load: imbalance of muscle strength and fascial contracture are important factors causing limb deformity, while abnormal load will make the deformity worse.
4. limb disuse: the growth and development of limbs are closely related to normal physiological activities. Paralysis of limbs leads to poor nutrition and further atrophy of muscles. Osteoporosis decalcified, cortex atrophy and thinning. Due to the poor blood supply to the limbs, the extremities are cold, and in severe cases, frostbite occurs in winter.
16. What are the principles of rehabilitation treatment for polio sequelae?
Sequela of poliomyelitis is a serious disabling disease, which results in lifelong disability of children's limbs. It affects children's life, growth and maturity, which not only causes children's physical deformity, but also causes serious obstacles to children's self-care, study and entry into society, which has hit children in all aspects of body and mind.
Therefore, the treatment of this disease should be based on the children's comprehensive obstacles and needs, so that they can get comprehensive rehabilitation treatment, that is, children should receive rehabilitation care and treatment not only physically but also mentally and socially, so that they can live, study and work like healthy people. Comprehensive rehabilitation generally includes medical rehabilitation, educational rehabilitation, vocational rehabilitation and social rehabilitation.
17. What is medical rehabilitation?
The application of medical means to the rehabilitation of patients with sequelae of infantile paralysis is called medical rehabilitation. Medical rehabilitation is an important aspect of patients' comprehensive rehabilitation. It runs through the whole process of patients' rehabilitation. This kind of work includes: surgical treatment, functional training, rehabilitation nursing, psychological rehabilitation, orthosis, walker and other rehabilitation projects, acupuncture, massage and other Chinese medicine treatments.
18. What is educational rehabilitation?
The application of cultural education and skill education to the rehabilitation of patients with sequelae of infantile paralysis is called educational rehabilitation. This work can promote their growth and development, and finally they can enter social life and take part in work. Especially for children with polio sequelae, although their limbs are disabled, their minds are sound and their intelligence is normal, so they should have the same right to education as normal children, and any discriminatory behavior in enrollment is wrong. On the contrary, because children have been devastated by serious diseases, their hearts have been traumatized to varying degrees, and we need the care, support and encouragement of healthy people.
19. What is vocational rehabilitation?
It is called occupational rehabilitation to promote patients with sequelae of infantile paralysis to acquire vocational skills and be competent for professional work. Disabled people hope to become self-reliant workers and become a member of society. They demand economic independence, which is an important issue for the comprehensive rehabilitation of disabled people. At present, the employment of disabled people is still difficult, and their economic income and living standards are below the national average. Therefore, the whole society should be concerned about the employment of disabled people, raise awareness, correct individual discriminatory views, and make disabled people truly useful, have a reliable source of income, and realize the ideal of returning to society.
For disabled children, families, schools and society should attach importance to their education and not discriminate against them. In addition to improving their cultural knowledge, we should also carry out appropriate vocational education according to the characteristics of disabilities. For example, children with polio sequelae who are paralyzed in both lower limbs can be trained to engage in upper limb activities, such as manipulating computers, carving, painting, accounting and so on. At the same time, we should also attach importance to the psychological education of children, establish a strong will and confidence to overcome difficulties, eliminate any pessimism, negativity and disappointment, work hard with optimism and make positive contributions to society.
2. What is social rehabilitation?
It is called social rehabilitation to improve the adaptability and living ability of patients with sequelae of infantile paralysis, and to transform the environment to help the disabled return to society. Socialist humanitarianism is one of the basic ideas of our society and the norm of interpersonal relationship. It is the unshirkable responsibility of the whole society to carry forward the fine tradition of helping the weak and the disabled and create the necessary conditions for the disabled to participate in society on an equal footing. At the same time, encouraging disabled people to be self-respecting, self-reliant, self-reliant, facing reality, overcoming difficulties, working hard and participating in society with a healthy attitude is an important aspect to realize the goal of social rehabilitation. In short, the social rehabilitation of the disabled is to work together from the social environment and the disabled themselves to create conditions for the disabled to participate in all aspects of society on an equal footing, truly enjoy their due social rights and become the masters of society.
21. Can patients with polio sequelae get married and have children?
Young people make friends with the opposite sex, and then get married and form a family. Childbearing is the need of human nature and an important part of everyone's life. There is no doubt that patients with polio sequelae need to make friends, get married and form a family just like healthy people. Medical experts have long pointed out that disabled people with polio sequelae have the same family life ability as healthy people, and this disease is not passed on to the next generation. However, due to their physical disability, they do have some difficulties in making foreign friends and realizing their family life, which needs everyone's care, understanding and help. Many work units and communities care about the disabled, match them up and introduce them, some organize disabled youth clubs to expand their contact, and some places set up marriage agencies for the disabled, all of which have done a lot of real work for disabled friends.
Patients with polio sequelae can form families. However, it should be pointed out that the disabled themselves have disabilities, and there are some difficulties in self-care, and some even need to be taken care of by others. Therefore, family planning should be implemented in fertility so as not to increase their own difficulties and pressures and affect the growth and development of the next generation. Especially for female patients, we should pay more attention to: some lesbians may have difficulties when the fetus is born if they suffer from scoliosis, pelvic tilt or poor pelvic development, so it is best to have prenatal checkups regularly during pregnancy and decide how to have a baby under the guidance of a doctor to ensure the safety of mother and child.
Three basic problems must be considered in the treatment of severe infantile paralysis: firstly, the indication of operation, secondly, the effect of operation, and thirdly, the patient and social factors. Now we will discuss these three aspects.
3.1 On surgical indications: Severe infantile paralysis has a wide range of muscles involved, and the available muscles are very limited. Coupled with long-term passive posture, patients often have joint deformities or even pelvic tilt, scoliosis and other secondary pathological changes, which makes it difficult for doctors to determine surgical indications. Some unprofessional grassroots doctors may find it difficult to determine whether such patients can be treated, so they are likely to come to the conclusion that they cannot be treated. One patient in this group came to our hospital after crawling for 15 years, because he listened to the incurable conclusion given by the local doctor and gave up further diagnosis and treatment. In fact, the indication of operation is relative. If there is still a group or even a muscle with a strength of 4 in the limb with generalized paralysis, doctors can use it to replace the main functional muscle. In this group, only tensor fascia lata and sartorius muscle can be used in a case of extensive paralysis of lower limbs. After quadriceps femoris replacement, the patient not only partially recovered his knee extension function, but also corrected the flexion and external rotation deformity of knee joint caused by iliotibial tract contracture, and the patient can walk with crutches. Although the surgical indications of severe infantile paralysis are not easy to determine, as long as the patients can make progress on the original basis after operation, such as walking with crutches or abandoning crutches, they should be actively treated.
3.2 about the surgical effect: the surgical effect of severe infantile paralysis is closely related to the selection of surgical indications and the design and implementation of surgical methods. Due to the serious loss of muscle strength of severe infantile paralysis, which is often accompanied by obvious deformity, it is difficult to achieve the ideal effect in one or two operations, so the patient should make a reasonable treatment plan through careful muscle strength examination after admission. We should not only pay attention to the local situation, but also consider the special requirements of the patient's gender, occupation and living environment. In theory or principle, the treatment of infantile paralysis is to correct the skeletal deformity first, and then perform muscle balance surgery. However, due to the particularity of severe infantile paralysis, if it is handled according to the above principles, it is likely that patients will be difficult to accept multiple operations. Therefore, it advocates "soft and hard combination", that is, at the same time of soft tissue surgery, the same or opposite bone surgery is completed in one stage. The contradiction is fixation, that is, the fixation time of soft tissue surgery is shorter than that of bone surgery, which requires doctors to make reasonable arrangements and give consideration to each other when making treatment plans. Generally speaking, the contralateral bone surgery is performed at the same time as the unilateral soft tissue surgery, or the soft tissue surgery below the ipsilateral calf is performed at the same time as the thigh and hip bone surgery. The surgical plan of this group of cases was basically formulated according to this viewpoint. As a result, the hospitalization time was shortened, the number of operations was reduced, the burden on patients was reduced, and the surgical effect was improved.