Poliomyelitis (polio), also known as poliomyelitis, is an acute infectious disease caused by poliovirus. Clinical manifestations include fever, sore throat and limb pain, and flaccid paralysis may occur in some patients. Infantile paralysis is also known as poliomyelitis because of the high incidence in children compared to adults.
The incubation period of the disease is 5 to 14 days, and it can manifest clinically in various types.
(1) occult infection;
(2) Stunted type;
③No paralysis type;
④paralysis type.
(a) The main symptoms of the prodromal period are fever, loss of appetite, excessive sweating, irritability and general sensory allergy; also seen
poliomyelitis
nausea. Vomiting, headache, sore throat, constipation, diffuse abdominal pain, rhinitis, cough, pharyngeal exudate, diarrhea, etc., lasting 1~4 days. If the disease does not progress, it is a stone-cold type.
(B) L~6 days after the disappearance of symptoms in the prodromal phase of pre-paralysis, the body temperature rises again, headache, nausea, vomiting is severe, skin is red, there is transient bladder sphincter disorder, tonic burning pain in the posterior neck muscle group, trunk and limbs, and constipation is often present. Physical examination reveals.
①Triangular frame sign: the patient needs to sit up with two hands posteriorly propped on the bed like a triangular frame to support the position;
(ii) Positive kissing knee test, i.e. the patient’s lips cannot touch the knee when sitting up and bending the neck;
(③) Head drop sign, that is, when the patient’s hand is placed under the shoulder and the trunk is lifted, the head is parallel to the trunk in normal people. If the condition ends here and the fever subsides after 3~5 days, it is a non-paralytic type. If the condition continues to develop, the key reflexes often change 12~24 hours before the paralysis, initially shallow reflexes and later deep tendon reflexes are suppressed, so early detection of reflex changes has important clinical diagnostic value.
(C) The paralysis period starts from the 3rd or 4th day of the pre-paralysis period, and most of the paralysis appears when the body temperature starts to drop and gradually worsens. When the body temperature recedes to normal, the paralysis stops developing and there is no sensory impairment. It can be divided into the following types.
1, spinal type This type is the most common. The lower limbs and large muscle groups are more likely to be involved than the upper limbs and small muscle groups, but only a single muscle group may be involved or all limbs may be paralyzed. If the dorsal cervical muscles, septal muscles and intercostal muscles are involved, there will be difficulty in sitting up and sitting down, respiratory movement disorders and paradoxical breathing.
2. The medullary type, also known as spherical type, is caused by the violation of the motor nucleus of the cranial nerve and the respiratory and circulatory centers of the medulla oblongata. When the respiratory center is damaged, irregular breathing and apnea occur; when the vasomotor center is damaged, there may be changes in blood pressure and pulse rate, both of which are fatal lesions. When the cranial nerve is damaged, the corresponding nerve paralysis symptoms and signs appear, with facial nerve and X to cranial nerve damage is more common.
3, brain type this type is rare; manifested as high fever, restlessness, convulsions or drowsy coma, with upper motor neuron spastic paralysis performance.
4, mixed type of the above types of simultaneous performance.
(IV) Recovery period of paralysis starts from the distal limb and lasts for several weeks to months, with complete recovery within 8 months in general cases and 6~18 months or longer in severe cases.
(E) The sequelae period is severe with atrophy of the affected muscles and failure to recover nerve function, resulting in deformity of the affected limb. In some paralytic cases, progressive neuromuscular weakness and pain occur decades after infection, and the paralysis of the affected limb increases, which is called “post-polio muscular atrophy syndrome”. The cause of the disease is unknown.
After the body temperature is normalized, the muscle pain disappears and the paralysis stops developing, active functional recovery treatment should be carried out, such as massage, acupuncture, active and passive exercise and other physical therapy measures.
1, acupuncture treatment Suitable for small age short course limb atrophy is not obvious can be taken according to the site of paralysis upper limb often take the neck pinch points, shoulder chastity big vertebrae hand three miles less sea within the shuttle valley after the stream each time choose 2 to 3 points lower limb often choose the lumbar spine next to the open 1 inch ring jumping rank side jumping Yu Shu thigh Guan Yin Lian four strong Fu rabbit Cheng Fu Yin door Ji Zhong Yang Ling Quan foot three miles solve the stream Tai Xi absolute bone wind city Cheng Shan fall ground according to the main muscle involved in the paralyzed limb According to the main muscle groups involved in the paralyzed limb, 3 to 4 points can be selected and rotated each time. 10 to 15 times a day is a course of treatment. 3 to 5 days between the second course of treatment, strong stimulation is used at the beginning of the treatment to obtain the efficacy and then change to medium stimulation to consolidate the efficacy.
2.Tui-na therapy Roll the paralyzed limb back and forth for 8-10 minutes by rolling and rubbing the relaxed joints for 3-5 minutes and rubbing the spine and limbs 5-6 times and rubbing heat locally by rubbing once a day or every other day can be taught to family members at home.
3, functional exercise paralysis heavy limb can not move the first massage massage to promote blood circulation of the affected limb to improve muscle nutrition and nerve regulation to enhance muscle strength the affected limb can make slight movements and muscle strength is very poor can help them to make extension and flexion abduction induction and other passive movements the limb can move and muscle strength is still poor encourage patients to make automatic movement sports therapy with the help of physical therapy tools to exercise muscle strength and correct deformities.
4.Physiotherapy can use hydrotherapy electrotherapy wax therapy light therapy, etc. to promote the relaxation of the diseased muscle to enhance local blood flow and inflammation absorption.
5, other available cupping (fire cans, water cans, gas cans) and Chinese herbal fumigation to promote recovery of paralyzed limbs, there are also reports of the application of acupoint stimulation ligation therapy to promote longer paralyzed limbs to enhance muscle strength deformed limbs can be fixed with wooden boards or plaster and surgical correction.