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(錢江晚報)從拿不起水杯,到能獨立洗臉,71歲大伯中風康復只花20天
作者:佚名    文章來源:本站原創    點擊數:    更新時間:2019/5/8

治療師正在用下肢機器人為患者做康復鍛煉。

  昨日上午,杭州的小劉(化名)陪著父親到浙江中醫藥大學附屬第三醫院(浙江省中山醫院)濱江康復院區(浙江康復醫療中心)做康復訓練。他一邊協助治療師,一邊對錢江晚報記者說:“本以為父親下半輩子得躺在床上,吃喝拉撒靠人服侍,沒想到現在還能自己刷牙、洗臉。”

  正說著話,一旁的劉大伯握住湯勺往嘴里送,小劉忍不住拍手,連說幾次真好,并用手機拍下了這一刻。

  和許多中風患者出院后回家養養不同,在父親出院的當天下午,小劉就將他從浙江省中山醫院莫干山路院區轉到康復院區,實現從治療到康復的無縫對接。

  病情平穩48小時介入康復

  中風后實現獨立洗臉、刷牙

  小劉父親71歲,一個多月前突發中風,在家屬提供的手機照片、視頻中,他言語含糊,無法交流,口角歪斜,右側肢體癱瘓,不能活動。“之前父親根本不能吃飯,進食即嗆,完全依靠胃管進食糊狀食物。”他說,中風給父親造成了語言障礙、運動障礙、吞咽障礙等一系列后遺癥。

  據統計,我國每年新發中風患者200多萬,超過70%會出現各種功能障礙,不僅嚴重影響患者的生活質量,還給家庭帶來沉重負擔。

  浙江省中山醫院康復科陳靜主任說,中風如今已是常見病、多發病,實現生活自理是患者和家屬的迫切需求,而及時、規范的康復訓練至關重要。“康復治療的時間越早越好,一般來說,病情平穩48小時后就可介入康復治療。”

  比如針對小劉父親的情況,醫生、治療師、護士組成治療小組,精準康復包括上下肢康復機器人、三維步態分析、情景模擬康復訓練、平衡評估訓練、水療、高壓氧等。康復治療還與日常生活結合,教患者洗菜、切菜、擺餐桌、就餐……

  從完全癱瘓不能動,依靠胃管進食到扶著可以走、正常吃飯,再到自己刷牙洗臉,小劉父親花了20天時間。在此過程中,治療小組一共進行了3次康復評定,下一階段會將他轉到社區繼續康復。

  7歲男孩3個月學會獨自走路

  兒童康復就像在游樂園玩耍

  錢報記者在浙江康復醫療中心轉了轉,很快就被兒童康復中心吸引了,這里色彩明亮,不時傳出孩子的歡笑聲,它也是腦癱、孤獨癥及學習困難兒童的“家”。

  治療室里,7歲的大圓(化名)在搖鈴聲的引導下,正一步一步向著康復師和奶奶走去。如果看臉蛋,你不會覺得這個濃眉大眼的孩子有什么異樣,但他緩慢走路的姿勢又透露出不同。

  奶奶說,大圓因難產腦部缺血缺氧,到了3歲還不會爬、不會翻身,確診為腦癱,在7歲之前都要靠攙扶,才能勉強地向前邁幾步。“全家人最大的心愿就是大圓能獨立行走。”奶奶說,直到孫子來浙江康復醫療中心3個月才最終圓夢,當時,他爸爸都激動地落淚了。

  腦癱兒童存在不同程度的運動和認知障礙。最近國際、國內指南及兒童康復臨床醫生都建議越早發現問題、越早進行康復越好。

  其實,大圓此前已在其他康復機構進行4年康復治療,不過效果不好。在矯金玲醫生看來,并不是大圓不努力,也不是家人配合不好,而是之前的方法不適合。

  “很多家長認為腦癱兒不能走路,在于腿部的力量不夠,事實并非如此,走路感覺的建立、肌肉之間的協調能力反而對于腦癱兒的獨立行走有著更加重要的意義。”她解釋。

  對此,矯金玲醫生通過下肢機器人讓大圓熟悉走路的感覺,同時結合物理治療來改善他運動協調能力差、運動鏈受限的問題。

  如今,大圓一周來浙江康復醫療中心5天。在多感官訓練室,他和其他孩子拍皮球蕩秋千搭積木。再去隔壁診室,聆聽音樂旋律或特定聲源,在康復師一對一的引導下,去傾聽分辨想象來自生活和自然界的不同聲音。還會有VR游戲,模擬摘蘋果以改善上肢運動功能。

  這些項目,聽上去像不像在游樂園玩耍?大圓可是非常喜歡呢。等到累了,他還能到中藥熏蒸室來個中藥SPA,改善肌張力,提高抵抗力。

  骨傷康復和神經康復最熱門

  設施遠超健身中心

  相比綜合性醫院的康復科,浙江康復醫療中心專科更細分,設有神經康復、骨傷康復、老年康復、心肺康復、中醫康復、兒童康復、心理康復共六大中心。

  錢報記者找到浙江省中山醫院副院長、浙江康復醫療中心執行院長高宏時,他正在婉拒一位帕金森病患者的加床需求。“希望住院的越來越多,中心一共252張床位,加到316張,還是不夠用。”

  高宏院長說,最熱門的是骨傷康復和神經康復。老年退行性骨關節疾病、骨折術后及截肢病人的功能康復、關節置換后的功能康復等,對病人將來的生活質量相當重要。系列康復所需的設備,遠超錢報記者眼中健身中心的整體規模。

  如何讓臨床治療與康復無縫對接,特別有講究。彭先生遭遇車禍被送到浙江省中山醫院,由于傷情嚴重,不得不截肢,在術前會議時,骨科醫生和康復治療師一起商量手術方案,截肢到什么部位合適,這與日后康復、假肢制作費用息息相關。

  在國外,康復醫學與預防、臨床治療并重,歐美國家的康復醫學有幾近百年的發展史。很多進行過大型手術或功能障礙的患者,都會盡早、持續進行康復治療以回歸社會和家庭。“康復并不是養老,也不是臨終關懷。臨床醫學是解決疾病本身,而康復醫學是通過各種手段來改善各種功能障礙,它貫穿生命全過程。”高宏院長說。

文章錄入:外聯    責任編輯:外聯 

浙江中醫藥大學附屬第三醫院 地 址:杭州市莫干山路219號(莫干山院區)/杭州市慶春路23號(慶春院區) 管理登錄 醫院辦公網(院外)
電話:0571-88393542(莫干山路院區)/87238121(慶春路院區) 浙江名中醫館0571-87238010 浙ICP備14003135號-2

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