What is paraplegia? What causes paraplegia?
Paraplegia is the paralysis of two lower limbs, unable to move, at the same time have limb sensory disorders, there will be varying degrees of defecation dysfunction.
Paraplegia is often caused by spinal cord injury, such as traffic accidents, industrial accidents, sports injuries, gunshot wounds, etc. when the spinal cord injury, will appear paraplegia, known as traumatic paraplegia. This manual mainly introduces the community rehabilitation knowledge of people with traumatic paralysis.
In addition to trauma, spinal cord inflammation, tumors, or other lesions can also cause paraplegia.
Why does spinal cord injury cause paraplegia? The spinal cord is in the vertebral canal of vertebra bone formerly inside, it is a component of central nerve, have conduction function, spinal cord is located inside the canal of spinal column, before be vertebral body, it is spinous solid behind. The spinal cord is cylindrical, 45 cm long for men and 42 cm long for women. The upper end is connected to the brain and the lower end becomes thinner to the lower margin of the first lumbar vertebra.
The spinal cord is divided into 31 segments, namely 8 cervical segments, 12 thoracic segments, 5 lumbar segments, 5 sacral segments and 1 caudal segment.
Vertebral body, spinal cord the movement of the spine to the brain to release and conduct "instruction", "information" to the limb trunk muscles, causing muscle movement, if the damage to the spinal cord, the conduction function is lost, the muscles of the limbs and trunk can't accept brain movement from "instruction" and "information", so he can't be voluntary movement, the formation of paralysis.
Spinal cord is responsible for the superficial and deep sensation of the limbs to the brain, spinal cord damage, this sense of conduction function is also lost, therefore, will appear at the same time limb sensory disorders.
Spinal cord still has a kind of function, can adjust urinate namely, defecate and sexual function activity, this is to be located by the reflex center of lumbar, sacral ministry spinal cord is responsible for undertake adjusting, so, when lumbar, sacral ministry spinal cord is damaged, can appear again urinate and defecate functional obstacle, and sexual function obstacle.
How does paraplegia patient undertake ego rehabilitation nurse?
1. Sit. After traumatic illness is stable, the operation or method of traditional Chinese medicine of rachis reductive have ended, operation knife edge and get hurt place heal completely, want to practice to sit. Get help sitting up and lying down. Lie down and sit up again. Do this twice a day, 20 times a day. General thoracic vertebra reachs the injury below thoracic vertebra, can do after two months of uninterrupted exercise. During this period, cooperate to do the following action, better result is better: straighten two legs, pull the toe of two feet with the hand, pull hard to oneself direction, feel coxal and waist have the feeling that tighten up so far, pull 15 times every time.
2. Practice climb. Lie prone on the bed face down first, two arms support next, make the body becomes kneel to crawl a form, drive coxal hind with the force of bosom waist carry leg high, carry left leg first, carry right leg again. Do it for 15 minutes at a time. After about a month of practice, the hips do not sway around, and then use the upper body to move the legs forward. Take care not to rub your knees, tailbone and other parts with sponges. Crawl carefully before single bed practice, had better be to go up in the ground spread on the sea cotton mat practice.
3. To practice. Patients with around one's neck, by two people to move it to the wall, make the patient back against the wall, and then respectively out close to the patient's leg against the hips and thighs, make patient two bow legs forward with the help of others to stand up straight, so after about half a year, the patient's arms and waist have the power, the patient often stand close to the walls of two t-shaped wooden stake, was buried a higher short, or right high left low, or vice versa; With the patient can hold a hand to pull, feel comfortable is accurate, the patient can borrow the force that holds a pull to adjust the body, make double leg stands straight. Can exercise leg muscle so, stimulative whole body blood circulates. Note: t-posts should be strong. Two iron pipes can be used to make handrails in buildings. They should be firm.
The picture shows the paraplegic walker produced by our center. It is applicable to paraplegia patients caused by all kinds of paraplegia, to assist paraplegia patients to achieve the purpose of practical and independent walking, to the greatest extent to meet the desire of paraplegia patients to live by themselves.
The picture shows the alternating gait walker produced by our center, which is suitable for patients with complete or higher incomplete spinal cord injury below the chest caused by various reasons
Relieve urination. When the patient urinates regularly, push the anus with fingers together and push it loose, push it loose again, until he no longer urinates. Sit to urinate when can fold toilet paper into a wad of 6 centimeters of left and right sides, cushion is in urinal place wet throw away again change; If you urinate standing up, you can use a thin plastic bottle with a diameter of less than 8 cm, tie a cloth belt at the mouth of the bottle, put it into a trouser tube, and then put the male genitalia into the mouth of the bottle, and tie the cloth belt to the bottom of the underwear, with the genitalia both in the mouth and not stuck shall be subject to. If the patient is a woman, can only pad toilet paper, frequent urination.
Get rid of your shit. Lean on the head of a bed go up, put double leg in the bed, put whole buttock to be placed outside the transverse edge of the bed to hold the bed with the hand, make buttock leans toward the ground as far as possible, make fluctuation motion form, free a hand to push knead the abdomen flank below two ribs at the same time, this is very easy defecate.
Treat bedsores. If bedsores occur accidentally, clean them with hydrogen peroxide after breaking them. Patients who are not allergic to them can take penicillin injection or directly apply penicillin facial agent to the wound twice a day. Note: the place that gives birth to bedsore must not press again, the measure that prevents pressing is to sew a cloth bag with cotton cloth and bedplate general wide, in the interval digs a diameter 18 centimeters round hole, put bedsore place when turning over, ok.
How does paraplegic patient choose daily life to assist implement and things?
Appropriate selection of some daily life AIDS can improve the ability of paraplegic people to their own activities, so as to save energy, save time to complete some of the original can not complete the daily life activities, so as to improve the independence of life.
Wheelchair, bedsore prevention cushion, food, excretion, washing gargle and other daily life activities auxiliary equipment are often used by paraplegics, are introduced as follows:
1, wheelchair
A necessary alternative to walking for paraplegics.
2, anti-bedsore mattress, seat cushion
Choose good mattess and cushion to prevent bedsore to have help extremely, the performance of cushion should make bearing area increases as far as possible, at the same time convenient skin peptide comes loose heat, breathe freely, commonly used have sponge cushion, inflatable cushion, and even pressure cushion, mattess also should choose even pressure mattess.
3. Auxiliary equipment for daily life activities
Have a meal, excrete, wash a face, comb hair, dress, strip clothes to wait for the activity that is the most important daily life, through rehabilitation training, have the help of daily life auxiliary appliance again, paraplegic personage need not rely on others, and can finish as far as possible oneself.
(1) eating AIDS: suitable for high paraplegia and the loss of grip strength of people to use. A commonly used one is made up of a hard belt around the palm, which is fastened with Velcro. There is a socket on the palm side of the belt, which is connected to the eating utensils, and the patient can eat. This heart still has a kind of concave plastic to eat clip: person of paraplegia of high position slips palm from the concave opening of plastic form, after relying on plastic flexibility, firm clip holds palm, concave plastic clip palm side has a socket, handle of food utensils is inserted can be used to eat.
(2) excretion AIDS: such as chair toilet: good stability, can be installed on the small wheel, or in the wheelchair on the toilet.
(3) wash face towel cover: towel as gloves, with water to wash your face, bath.