Polio is an acute disease caused by the polio virus. There are three types of the virus, 1, 2, and 3. The incubation period is from five to thirty-five days, but usually seven to fourteen days, especially in cases with paralysis. Patients may have mild symptoms such as fever, headache, sore throat, vomiting, diarrhea, or constipation. A small number of patients may experience muscle pain and weakness of the limbs and facial muscles. Breathing and eating functions may be affected, which can be life-threatening. Poliomyelitis, commonly known as polio, is caused by the poliovirus. The virus is mainly transmitted by dietary contamination or droplets and damages the motor neurons in the anterior horn of the spinal cord (lower motor neurons). It manifests as paralysis after 3-4 days of fever in the pre-paralytic phase or after a drop in body temperature, and can be spinal, medullary, encephalitis, or mixed. After 1-2 weeks of recovery, the diseased muscle recovers, or a persistent post-paralytic disease develops.
In general, disability is more common than death. The outcome varies according to the condition (paralysis or no paralysis) and the part of the body affected. In more than 90% of cases, the brain and spinal cord are unaffected and full recovery is possible.
How is polio spread?
Polio is mainly spread through feces. It can also be spread through fecal-contaminated food and milk. There is no evidence that the disease is spread by insects.
How can polio be prevented?
Travelers should be immunized before departure. The polio vaccine protects most people from infection (over 90% effective). There are two types of vaccines: oral and injectable. Vaccination should be started at infancy. The minimum number of doses is three, and the maximum number of doses is four (more doses may be needed in endemic areas). Travelers who have not completed the vaccination program should consult their family doctors. Food (including dairy products) that is suspected to be contaminated must be avoided while traveling.
How is polio treated?
The mainstay of treatment is symptom control and natural resolution of the infection. Symptomatic treatments include painkillers, physiotherapy, braces and orthopedic shoes, and even surgery to promote muscle function. In severe cases, the patient may need to rely on assisted breathing devices to stay alive.
Polio sequelae of disability is how to form
Polio sequelae of disability is how to form
Polio children in the early stages of the disease, muscle atrophy and paralysis of the limbs, but the paralyzed limbs do not have deformities, but with the prolongation of the course of the disease, and then slowly appeared a variety of deformities. The main reasons are: ① Part of the muscles that govern the limb are paralyzed, resulting in an imbalance of strength between different muscles. For example, if the muscles governing the external rotation of the foot are paralyzed and the muscles governing the internal rotation of the foot are not paralyzed, resulting in an imbalance of strength between the two sides of the foot, with the inner side being strong and the outer side being weak, the internal rotation of the foot will occur. ② soft tissue contracture around the joints of the affected limb, resulting in deformity. For example, the contracture of the soft tissue behind the knee joint will cause the deformity of the knee flexion and extension. ③ Unusual weight-bearing activities such as walking aggravate the deformity. For example, the deformity of muscle imbalance or soft tissue contracture mentioned above can be corrected at an early stage, but the patient does not understand this, but continues to walk or do other activities under abnormal posture, which will aggravate the deformity; on the contrary, if a splint is applied to fix the limb in the posture of a healthy person, the deformity can be prevented from occurring. ④The useless inactivity of the limb is another important cause of deformity. After the onset of the child limb paralysis, inactivity, and limb growth and development is closely related to the body's normal physiological activities, limb paralysis and inactivity results in the affected limb of the bones, muscles and other soft tissues of the development of delayed, or even degradation, and the affected limb is short, thin, loose joints, or even dislocation. ⑤ Long-term maintenance of poor posture is another important factor in producing limb deformity. For example, if the child is paralyzed and sits cross-legged for a long time, it will cause the deformity of hip and knee flexion and extension. Prolonged chest and waist straight bending sitting posture will cause spinal curvature deformity.
Additionally, children with long-term paralysis resulting in limb disability and deformity, the main reasons are:
1. Imbalance of muscle power: normal limbs, a part of the extensor and flexor muscles, adductor and abductor muscles, adductor and extensor muscles, are in a state of confrontation and balance. When a certain part, a group of muscles paralyzed, while the antagonistic group of muscle strength is normal, the physiological balance is disrupted. Initially, with the unidirectional movement of the muscle contraction, in the long run, the muscle, fascia and joint capsule and other soft tissue atrophy occurs, and further development of bone and joint deformity.
2. Degeneration of muscle and fascia: Due to long-term paralysis of muscle, muscle degeneration occurs, fascia thickening and contracture, resulting in limb deformity.
3. Abnormal weight bearing: muscle imbalance and fascial contracture are important factors causing limb deformity, while abnormal weight bearing contributes to the deterioration of deformity.
4. Waste of limbs: the growth and development of limbs and normal physiological activities have a close relationship. Paralyzed limbs waste, so that its poor nutrition, muscle further atrophy. Osteoporosis decalcification, cortical atrophy and thinning. Due to the poor blood supply to the limbs, causing the extremities to be cold, and in severe cases, frostbite occurs in winter.
16. What is the principle of rehabilitation treatment for post-polio sequelae?
Polio sequelae is a serious disabling disease, the onset of which results in lifelong disability of the child's limbs. It affects the child's life, growth and maturity, and not only causes physical deformities but also creates serious obstacles to the child's self-care, learning, and entry into the community, so that the child's physical and mental aspects have been hit.
So the treatment of this disease should be dealt with from the overall obstacles and needs of the children, so that they get a comprehensive rehabilitation, that is, not only the physical but also the mental and social life of the children should be rehabilitated to care for and treat, so that they and the healthy people as living, learning and working. 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 pediatric anesthesia is called medical rehabilitation. Medical rehabilitation is an important aspect of the patient's overall recovery. It runs through the whole process of the patient's rehabilitation. This kind of work includes: surgical treatment, functional training, rehabilitation care, psychological rehabilitation, rehabilitation works such as orthopedic devices and walking aids, traditional Chinese medicine such as acupuncture and massage, and so on.
18, what is educational rehabilitation?
The application of cultural education and skills education for the rehabilitation of pediatric anesthesia patients, known as educational rehabilitation. This work can promote their growth and development, and finally be able to enter the social life and participate in the work. Especially for children with polio sequelae, they are physically disabled, but the mind is sound, intelligence is normal, and therefore should have the same right to education as normal children, any discrimination in the enrollment and other aspects of the behavior is wrong. On the contrary, because the children have been devastated by serious illnesses, their minds are traumatized to varying degrees, and they need the care, support and encouragement of our able-bodied people even more.
19. What is vocational rehabilitation?
Promoting the acquisition of vocational skills by people with sequelae of pediatric anesthesia and their ability to perform vocational tasks is called vocational rehabilitation. Disabled people want to become self-reliant workers, become a part of society, they require financial independence, which is an important subject for the comprehensive rehabilitation of disabled patients. At present, the employment of disabled people is still difficult, economic income and standard of living in the country below the per capita level, so the whole society should *** with concern for the employment of disabled people, awareness-raising, to correct the individual's discriminatory views, so that people with disabilities really have a place to use, have a reliable source of economic resources, and to realize the return to the community's ideals.
For children with disabilities, families, schools and society should pay attention to their upbringing and education and not discriminate against them. In addition to improve their cultural knowledge, but also according to the characteristics of the disability to carry out appropriate vocational education, for example, post-polio children with paralysis of both lower limbs, they can be trained to engage in the activities of the upper limbs of the work, like manipulation of computers, carving, painting, accounting and so on. At the same time, we also need to pay attention to the psychological education of the children, to establish a strong will and confidence in overcoming difficulties, to eliminate any pessimism, negativity, disappointment, to work hard with optimism, and actively contribute to society.
20, what is social rehabilitation?
Improving the ability of post-paediatric anesthesia patients to adapt to society and life, transforming the environment to help the disabled return to society is called social rehabilitation. Socialist humanitarianism is one of the basic ideas of our society, is the norm of human relations, carry forward the fine tradition of helping the weak and disabled, for the disabled to participate in society on an equal footing to create the necessary conditions for the whole society is incumbent upon the responsibility. At the same time, encouraging persons with disabilities to be self-respecting, self-improving and self-reliant, to face the reality, to overcome difficulties, to work hard and to participate in society with a healthy mindset is an important aspect of realizing the goal of social rehabilitation. In short, the social rehabilitation of persons with disabilities is to work together with the social environment and persons with disabilities themselves to create conditions for persons with disabilities to participate in all aspects of society on an equal footing and to truly enjoy the social rights and interests to which they are entitled. Become the master of society.
21. Can post-polio patients get married and have children?
Young people make friends of the opposite sex, and then get married, form a family, and have children is a natural human need, but also an important part of everyone's life. Post-polio patients and healthy people, also need to make friends, get married, form a family, there is no doubt, medical experts have long pointed out that the ability of post-polio disabled family life and the able-bodied is the same, and this disease is not hereditary to the next generation. However, due to the existence of physical and motor function disabilities, they do have certain difficulties in making heterogeneous friends and realizing the desire of family life, and they need everyone's care, understanding and help. Many work units and communities care about the disabled, matchmaking for them to introduce objects, some organize disabled youth fellowships to expand their contacts, and others have set up marriage agencies for the disabled, all of which do a lot of real work for disabled friends.
Post-polio patients are able to form families. But there is a point that should be raised, that is, the disabled themselves have disabilities, life more or less self-care difficulties, and some even need to be taken care of, so in the birth of a family planning, so as not to increase their own difficulties and pressures, but also affect the growth and development of the next generation. Especially for female patients should pay more attention to: some lesbians such as suffering from scoliosis, pelvic tilt or pelvic development is not good, so in the birth of the fetus may be difficult, so it is best to do regular prenatal checkups when you are pregnant, under the guidance of the doctor to decide how to give birth to a child in order to ensure that the mother and child safety.
There are three basic issues that must be taken into account in the treatment of severe pediatric paralysis: first, the indications for surgery, second, the results of surgery, and third, the patient and social factors. These three aspects are discussed.
3.1 On the question of indications for surgery: due to the wide range of affected muscles, the available muscles are very limited, coupled with the long-term passive posture, the patients have joint deformities or even secondary pathological changes such as pelvic tilt, scoliosis, etc., which makes it difficult for the doctors to determine the indications for surgery. Some less specialized primary care doctors are afraid that it is difficult to determine whether such patients can be treated, and therefore may make the conclusion that they are incurable. In our group, there is a case who came to our hospital after 15 years of crawling, but he gave up further treatment because he believed the conclusion of the local doctors that he was untreatable. In fact, the indications for surgery are relative, if there is a group or even a muscle of grade 4 strength in the widely paralyzed limb, the doctor can use it to replace the main functional muscle. In this group, in a case of lower limb generalized paralysis, the only available muscles were broad fascia tensor muscle and suture muscle. After quadriceps replacement surgery, the patient not only partially regained the function of knee extension, but also corrected the deformity of knee flexion and external rotation due to iliotibial fascia contracture, and the patient was able to walk with the help of crutches. Although it is not easy to determine the indications for surgery for severe pediatric paralysis, as long as the patients can make progress on the basis of the original after surgery, such as walking with crutches or abandoning crutches, the treatment should be actively carried out.
3.2 Surgical outcome: The surgical outcome of severe pediatric paralysis is closely related to the selection of surgical indications and the design and implementation of surgical methods. Because of the severe loss of muscle strength and obvious deformity of severe pediatric paralysis, it is difficult to achieve the ideal effect in one or two operations, so the patient should be admitted to the hospital through careful muscle strength examination to formulate a reasonable treatment plan. It is important to pay attention not only to the local condition, but also to the patient's gender, occupation, and the special requirements of the living environment. Theoretically or in principle, the treatment of pediatric paralysis is to correct the bony deformity first, followed by muscle balancing surgery. However, due to the special nature of severe pediatric paralysis, patients may have difficulty in undergoing multiple surgeries if treated according to the above principle. Therefore, it is advocated to "combine soft and hard", i.e., to perform soft tissue surgery and at the same time complete the ipsilateral or contralateral bony surgery in one stage. The contradiction is the fixation problem, that is, the fixation time of soft tissue surgery is shorter than that of bone surgery, which requires the doctor to make reasonable arrangements when making the treatment plan to take into account each other. Generally, soft tissue surgery is performed on one side while bone surgery is performed on the opposite side, or thigh or hip bone surgery is performed while soft tissue surgery is performed on the same side below the calf. The surgical plan of this group of cases basically follows this point of view, and the result is to shorten the hospitalization time, reduce the number of surgeries, while reducing the burden on the patient and improving the surgical efficacy.