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[骨质疏松症的镇痛治疗与康复]

[Analgetic treatment and rehabilitation in osteoporosis].

作者信息

Ksiezopolska-Pietrzak K

出版信息

Pol Merkur Lekarski. 1998 Oct;5(28):218-21.

Abstract

Osteoporosis seems to be a component of body aging process. Through the years, muscles, ligaments, and fasciae loose their natural elasticity; degenerative changes form in joints; also, mechanical resistance of bones reduces. Involutive changes in central nervous system (CNS) cause disturbances in reciprocal transmission of impulses between CNS and muscles. This changes normal motion pattern, leading, consequently, to lasting stress of ligaments, muscles, joints and bones, what becomes a source of strong nociceptive impulses. One of first symptoms of this is pain, localized particularly in spine region. Pain is another cause of increased, abnormal tension of muscles and, thus, of their stress. Proper treatment of above situation must be necessarily consisted of simultaneous analgesia, correcting of muscle tension and relaxation. Therefore, guideline for the rehabilitation program needs to be supported by thorough clinical, biomechanical, roentgenographic and densitometrical case analysis. Rehabilitation works as prophylactics of formation and fixing of deformities. Therefore, this must be aimed to: pain relief, maintaining of proper patient's stance, rebuilding of normal muscle force, maintaining of normal motion range and increasing of daily motion activity, what would stimulate skeletal system. For practical reasons, forming of dysfunctions in motion system in course of osteoporosis is classified into three stages--I--early, II--advanced osteoporosis and III--late.

摘要

骨质疏松似乎是身体衰老过程的一个组成部分。多年来,肌肉、韧带和筋膜失去其自然弹性;关节出现退行性变化;此外,骨骼的机械阻力降低。中枢神经系统(CNS)的退行性变化会导致CNS与肌肉之间冲动的相互传递受到干扰。这会改变正常的运动模式,从而导致韧带、肌肉、关节和骨骼持续受力,成为强烈伤害性冲动的来源。其最初症状之一就是疼痛,尤其集中在脊柱区域。疼痛又是肌肉张力增加和异常紧张的另一个原因,进而导致肌肉压力增大。对上述情况的恰当治疗必须包括同时进行镇痛、纠正肌肉张力和放松肌肉。因此,康复计划的指导方针需要有全面的临床、生物力学、X线和骨密度病例分析作为支撑。康复可预防畸形的形成和固定。因此,康复必须旨在:缓解疼痛、保持患者正确的姿势、重建正常的肌肉力量、维持正常的活动范围以及增加日常活动量,这将刺激骨骼系统。出于实际原因,骨质疏松症过程中运动系统功能障碍的形成分为三个阶段——I期——早期、II期——晚期骨质疏松症和III期——后期。

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