Kirby N A
Division of Rehabilitation Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Nurs Clin North Am. 1989 Mar;24(1):179-91.
Persons with quadriplegia resulting from disease or trauma have an array of disabling impairments that involve virtually every body system. During the rehabilitation process, each impairment is addressed. This article presents alternatives in three areas: respiration, communication, and environmental control. The importance of tailoring strategies to the individual is emphasized throughout. Appropriate rehabilitation of the person with high quadriplegia goes beyond maintenance of life and health. An interdisciplinary team that includes the patient unites dreams, knowledge, skills, and technology so that the patient has the possibility of noninstitutional living, major control over his or her own destiny, some autonomy, and participation in a full spectrum of life activities. As Maddox noted: "Life is a fragile, fleeting thing, under any circumstances, and living it can be comic or tragic, weird or wonderful--regardless of one's motor limitations."
因疾病或创伤导致四肢瘫痪的人存在一系列致残性损伤，几乎涉及身体的每个系统。在康复过程中，要对每种损伤进行处理。本文介绍了三个方面的替代方案：呼吸、沟通和环境控制。文中始终强调根据个体情况量身定制策略的重要性。对高位四肢瘫痪患者进行适当的康复治疗，其意义远不止维持生命和健康。一个包括患者在内的跨学科团队将梦想、知识、技能和技术结合起来，使患者有可能过上非机构化的生活，对自己的命运有较大掌控权，拥有一定的自主权，并参与全方位的生活活动。正如马多克斯所指出的：“无论在何种情况下，生命都是脆弱而短暂的，无论运动能力如何受限，生活都可能是滑稽或悲惨的、怪异或美妙的。”
