周围神经损伤康复诊疗规范SOP中英文对照

StandardOperationProcedureforDiagnosisandTreatmentofPatientswithPeripheralNerveInjuryDirectoryI.purposeTherehabilitationnursingofpatientswithperipheralnerveinjurywasstandardized.II.RangePatientswithperipheralnerveinjurywhoneedrehabilitationcare.III.contentRehabilitationevaluation,1.Motorfunctionassessment:(1)visualexamination,theskiniscomplete,thereisnoswellingandmuscleatrophy,limbmalformation,abnormalgaitandposture.(2)limbcircumferencemeasurement.(3)thestrengthandrangeofmotionevaluation.2.Sensoryfunctionassessmentincluding:touch,pain,temperaturesensation,pressure,two-pointdiscrimination,skintopesthesia,skinpatterndiscrimination,tactile,positionsense,neuralstempercussiontestinourhospital.Byquantitativesensorytestingprovidesquantitativesensorytesting,provideobjectiveevidenceforrehabilitation.3.Electrophysiologicalassessment:intensitytimecurvethrough,chronaxiameasurementandcurvetracing,judgeforcompletedenervationofmuscleinnervation,partiallydenervatedandnormalnerve.4.EMG:ourhospitalcanbedetectedbyneedleelectromyography,nervedamagecanbejudgedisthedegreeofneuronallossintheaxonissevered,orGodThebrokenaway.5.Milddenervation:electromyographyshowedspontaneousactivity,motorunitpotentialamplitude,durationofnormalrecruitmentformixingandphaseinterference,normalnerveconductionvelocity,amplitudecanbedecreased.6.Moderatedenervation:electromyographyappearsmorespontaneouselectricalactivity,recruitmentonlytomixedphasenomorethan20%,nerveconductionvelocity,amplitudeislessthan7.50%,severedenervatedelectromyogram:theemergenceofalargenumberofspontaneousactivity,onlyasinglemotorunitpotential,motorunitpotentialamplitudecanbeincreased,timelimitcanbewidened.8.CompletedenervationofEMG:theemergenceofalargenumberofspontaneousactivity,nomotorunitpotentialelectricalstimulationofnervemuscle,notdetectedwithmuscleactionpotentials.9.Determinationofnerveconductionvelocity:Judgementofnerveinjuryandnerveregeneration.Recoverysituation.10.Theabilityofdailylivingactivities.

Activerehabilitationtreatment,1.Suchasnerveinjury:toalesserextent,musclestrengthwasabove2-3,canalsobecarriedoutintheearlyactivemovement.Movementisnottoolarge,especiallyinthenerveinjuries,nerveandtendon.Exerciseisaphysiologicalstimulus,thecentralnervoussystemmaintainthetensionandexcitement,andcanimprovethebloodcirculationofperipheralnervemyelin,reduceedemaaround.2.Holdfunction:afterperipheralnerveinjury,inordertopreventjointcontracture,retainthemostinvolvedpracticalfunction,shouldbepartoftheinjuryandnerveinnervationofthejointtomaintaingoodpostureinmostcases,shouldbemaintainedinafunctionalposition.3.Passiveactivity:withthehelpofthetherapistorinstrumentforcesmovementforpassivemovement,patienthealthmovementforselfhelpaffectedpartsofpassivepassivemotion.Themainfunctionofsportsinordertomaintainandincreasejointmobility,preventmusclecontracturedeformation.Secondlytomaintainphysiologicallengthandmuscletensionofmuscle,improvelocalcirculation.4.Physiotherapy:neuromuscularelectricalstimulationcanpromotenerveregeneration,soastopromotetherecoveryofperipheralnerveinjury.Afterperipheralnerveinjury,nerveinjurywithin1weekfunctionstimulationwithactiveandpassivemuscleexercise,canpromoteaxonalregeneration,promoteperipheralnervetomusclereinnervation.(1).theeffectofhyperthermiatherapy:earlyapplicationofshortwave,microwavediathermy(noheatorheat,1-2timesdaily),caneliminateinflammation,promotetheabsorptionofedema,facilitatenerveregeneration.Hotcompress,wax,infraredradiation,canimprovelocalbloodcirculation,relievepain,loosenadhesions,promotetheabsorptionofedema.Thetreatmentshouldpayattentiontosuitabletemperature,especiallywithsensoryimpairmentsandThebloodcirculationispoor,pronetoscald.Ifthepatientfeelslost,orpartsofthebodyinthetreatmentofmetalimplants,shouldbepulsedshortwaveorpulsedmicrowavetreatment.(2).lasertherapy:usedHeNelaser(10-20mw)orsemiconductorlaser(200-300mw)irradiationinjurysiteoralongthenervetowardtheselectionofacupointirradiationandeverypartof5-10minirradiationhaveanti-inflammatory,promotenerveregeneration.(3).watertreatment:usewarmwaterbath,whirlpoolbath,canrelievemuscletension,promotelocalcirculation,loosenadhesions.Passivemovementandactivemovementinthewater,canpreventmusclecontracture.Thebuoyancyofwaterhelpsparalyzedmusclesthemovement,theresistanceofthewaterinthewatermovementisslow,topreventtheoccurrenceofsportsinjuries.5.Hyperbaricoxygentherapyinclinicalpractice:hyperbaricoxygentherapyisalsousedinperipheralnerveinjury.6.Orthosistreatment:earlyPeriodtopreventcontracturedeformity.Thetreatmentandrehabilitationgoals1.Shorttermgoals:earlyrehabilitationgoalismainlyearlyeliminationofinflammation,edema,promotenerveregeneration,preventlimbcontractures,recoverytimeobjectiveismainlypromotenerveregenerationandrecoveryofneurologicalfunction,correctionofthedeformity.2.Long-termgoal:tomakediseaserecovery,returntonormaldailylifeandsocial

末梢神经损伤患者的康复护理的标准操作规程一.目的对周围神经损伤的患者康复护理进行诊疗规范。二.范围：所用需要康复护理的周围神经损伤的患者。三.内容1.康复评定

(1).运动功能评定：视诊，皮肤是否完整，肌肉有无肿胀和萎缩，肢体有无畸形，步态和姿势有无异常。肢体周径测量。肌力和关节活动范围评定。

(2).感觉功能评定：包括触觉、痛觉、温度觉、压觉、两点辨别觉、皮肤定位觉、皮肤图形辨别觉、实体觉、位置觉、神经干叩击试验。我院可通过感觉定量检测仪提供感觉定量检测，为康复提供客观证据。

(3).电生理评定：强度时间曲线，通过时值测定和曲线描记，判断肌肉为完全失神经支配，部分失神经支配和正常神经支配。

(4).肌电图检查：我院可通过针极肌电图检测，可判断神经受损是程度是神经失用，轴突断离或神经断离。

(5).轻度失神经支配：肌电图可见自发电活动，运动单位电位波幅、时限基本正常，募集相为混合和干扰相，神经传导速度正常，波幅可下降。

(6).中度失神经支配：肌电图出现较多自发电活动，募集相为单纯至混合相，神经传导速度不超过20%，波幅下降不超过50%。

(7).重度失神经支配：肌电图出现大量自发电活动，仅见单个运动单位电位，运动单位电位波幅可增高，时限可增宽。

(8).完全失神经支配：肌电图出现大量自发电活动，无运动单位电位出现，电刺激神经干相应肌肉检测不到符合肌肉动作电位。

(9).神经传导