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广泛物理治疗康复用于肺结核和结核性脑膜炎伴脑室腹腔分流术:病例报告

Extensive Physiotherapy Rehabilitation for Pulmonary Tuberculosis and Tuberculous Meningitis With Ventriculoperitoneal Shunting: A Case Report.

作者信息

Aherrao Samruddhi, Harjpal Pallavi, Tikariha Anshu

机构信息

Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND.

Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND.

出版信息

Cureus. 2024 Sep 30;16(9):e70578. doi: 10.7759/cureus.70578. eCollection 2024 Sep.

Abstract

Tuberculous meningitis (TBM), an advanced form of extrapulmonary tuberculosis (TB), is caused by infection of the meninges surrounding the brain and spinal cord. If it is not promptly and effectively treated, it can result in serious inflammatory reactions and neurological problems. TBM frequently leads to joint stiffness, discomfort, respiratory difficulties, swallowing difficulties, neurological deficits, and muscular weakness. Physiotherapy intervention is essential in treating these issues, as it provides individualized treatment strategies and programs that enhance muscle strength, motor coordination, and overall mobility. Acute TB is a disease that spreads through the bloodstream due to the presence of TB bacteria. The mild, nonspecific clinical presentation, which typically mimics the central organ involved, makes diagnosis challenging. This case study explains how to enhance function, quality of life, and functional capacity. It examines a 43-year-old man who reports respiratory issues, swallowing difficulties, and generalized weakness. MRI results indicate a defect in the right parietal region, along with slight soft tissue swelling above it. A four-week physical therapy rehabilitation program was created based on the patient's limitations identified during the initial intensive care unit (ICU) phase. The primary objectives of physiotherapy were to promote postural balance, preserve joint integrity, initiate early bed mobility, enhance sensation by improving respiratory patterns and secretion mobilization, and assist the patient with transfers and activities of daily living (ADLs).

摘要

结核性脑膜炎(TBM)是肺外结核病的一种晚期形式,由感染脑和脊髓周围的脑膜引起。如果不及时有效地治疗,它会导致严重的炎症反应和神经问题。TBM常导致关节僵硬、不适、呼吸困难、吞咽困难、神经功能缺损和肌肉无力。物理治疗干预对于治疗这些问题至关重要,因为它提供个性化的治疗策略和方案,可增强肌肉力量、运动协调性和整体活动能力。急性结核病是一种因结核杆菌存在而通过血液传播的疾病。其轻微、非特异性的临床表现通常类似于所累及的中枢器官,这使得诊断具有挑战性。本病例研究解释了如何增强功能、提高生活质量和功能能力。它研究了一名43岁男性,该男性报告有呼吸问题、吞咽困难和全身无力。磁共振成像(MRI)结果显示右顶叶区域有缺损,其上方还有轻微软组织肿胀。根据患者在最初重症监护病房(ICU)阶段所确定的局限性,制定了一个为期四周的物理治疗康复计划。物理治疗的主要目标是促进姿势平衡、保持关节完整性、尽早开始床上活动、通过改善呼吸模式和分泌物排出增强感觉,以及协助患者进行转移和日常生活活动(ADL)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbd5/11525044/11a61664c117/cureus-0016-00000070578-i01.jpg

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