肌痉挛及处理ppt课件.pptx

1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller

2、and DS18B20 temperature sensor.概述概述 定义：定义： 痉挛是中枢神经系统损害后出现的痉挛是中枢神经系统损害后出现的肌肉张力异常增高的症候群，是一种由牵肌肉张力异常增高的症候群，是一种由牵张反射兴奋性增高所致的、以速度依赖的张反射兴奋性增高所致的、以速度依赖的紧张性牵张反射亢进为特征的运动功能障紧张性牵张反射亢进为特征的运动功能障碍。痉挛的速度依赖是指伴随肌肉牵伸速碍。痉挛的速度依赖是指伴随肌肉牵伸速度的增加，肌肉痉挛的程度也增高。度的增加，肌肉痉挛的程度也增高。This paper mainly introduces the design of an intel

3、ligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.概述概述 原因：原因： 中枢神经系统损害

4、后均可出现痉挛。中枢神经系统损害后均可出现痉挛。但临床上痉挛多见于脑卒中、脊髓损伤、但临床上痉挛多见于脑卒中、脊髓损伤、脊髓病变、脑瘫和多发性硬化症等。脊髓病变、脑瘫和多发性硬化症等。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 a

5、nd single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.概述 痉挛导致的临床问题：痉挛导致的临床问题： 痉挛是一种病理生理痉挛是一种病理生理状态。它对患者的影响包括：状态。它对患者的影响包括： 增加运动的阻力，使随意运动难以完成；增加运动的阻力，使随意运动难以完成； 由于阻力增加，运动迟缓，难以控制，难以完由于阻力增加，运动迟缓，难以控制，难以完成精巧的动作；成精巧的动作； 由于反应迟钝，动作协调困难，容易

6、摔倒；由于反应迟钝，动作协调困难，容易摔倒； 强直痉挛，不便护理，容易发生压疮等并发症；强直痉挛，不便护理，容易发生压疮等并发症； 影响步态和日常生活活动。影响步态和日常生活活动。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and

7、 single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.被动护理障碍This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus d

8、igital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement an

9、d control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的生理病理基础痉挛的生理病理基础 肌梭：肌肉由许多肌纤维组成，其中一部份特肌梭：肌肉由许多肌纤维组成，其中一部份特异化的肌纤维形成肌梭。肌梭是一种感受器，异化的肌纤维形成肌梭。肌梭是一种感受器，受受运动神经元支配，对肌

10、肉的牵拉刺激敏感，运动神经元支配，对肌肉的牵拉刺激敏感，肌肉收缩时肌梭被缩短。肌梭中有两种感觉纤肌肉收缩时肌梭被缩短。肌梭中有两种感觉纤维，一种对肌肉的维，一种对肌肉的运动速度运动速度敏感，另一种对敏感，另一种对肌肌肉的长度肉的长度敏感。二者都能发出反馈信息，通过敏感。二者都能发出反馈信息，通过兴奋或抑制脊髓兴奋或抑制脊髓运动神经元，控制主动肌、运动神经元，控制主动肌、协同肌、拮抗肌的活动，限制肌肉的过度活动，协同肌、拮抗肌的活动，限制肌肉的过度活动，保证动作的协调。保证动作的协调。This paper mainly introduces the design of an intelligen

11、t temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的生理病理基础痉挛的生理病理基础 脊髓前角运动

12、神经元脊髓前角运动神经元: 脊髓前角运动神经元分脊髓前角运动神经元分为大型的为大型的运动神经元和小型的运动神经元和小型的运动神经元。前运动神经元。前者发出纤维支配骨骼肌肌纤维，引起骨骼肌的收者发出纤维支配骨骼肌肌纤维，引起骨骼肌的收缩。后者支配肌梭内的梭内肌纤维，调节肌纤维缩。后者支配肌梭内的梭内肌纤维，调节肌纤维张力，对保持肌张力起着重要的作用。张力，对保持肌张力起着重要的作用。 脊髓上脊髓上和脊髓传入的各种兴奋和抑制信号，最后均进入和脊髓传入的各种兴奋和抑制信号，最后均进入脊髓前角运动神经元，称为最后公共通路。一定脊髓前角运动神经元，称为最后公共通路。一定数量信号的传入，兴奋和抑制的相对平

13、衡决定了数量信号的传入，兴奋和抑制的相对平衡决定了运动神经元何时活动及活动的比例。每一个运动运动神经元何时活动及活动的比例。每一个运动神经元的放电都向下传导到运动终板，结果产生神经元的放电都向下传导到运动终板，结果产生运动单位的收缩。运动单位的收缩。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus dig

14、ital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的生理病理基础痉挛的生理病理基础 脊髓前角运动神经元脊髓前角运动神经元: 自主性脊髓上传自主性脊髓上传入、反射性脊髓或脊髓上传入，或两者的入、反射性脊髓或脊髓上传入，或两者的联合作用，都可引起运动神经元的放电及联合作用，都可引起运动神经元的放电及引起肌肉收缩。引起肌肉收缩。 痉挛就是

15、来自节段上的痉挛就是来自节段上的传入信号部分或全部地减弱，脊髓或脊髓传入信号部分或全部地减弱，脊髓或脊髓下反射兴奋过度的结果。下反射兴奋过度的结果。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip mic

16、rocomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的生理病理基础痉挛的生理病理基础 锥体外系：锥体外系： 前额叶的辅助运动皮层、扣带前额叶的辅助运动皮层、扣带回、顶叶后中央回发出的皮质回、顶叶后中央回发出的皮质脊髓通路脊髓通路为锥体外系。锥体外系的功能主要是调节为锥体外系。锥体外系的功能主要是调节肌张力、协调各个肌肉的运动。锥体外系肌张力、协调各个肌肉的运动。锥体外系的活动是在锥体系主导下进行的，但锥体的活动是在锥体系主导下进行的，

17、但锥体外系也为锥体系提供了最适宜的行使功能外系也为锥体系提供了最适宜的行使功能的条件，只有在锥体外系使肢体保持稳定的条件，只有在锥体外系使肢体保持稳定并赋予肌肉适宜张力和协调的情况下，锥并赋予肌肉适宜张力和协调的情况下，锥体系才能执行精确的随意运动。体系才能执行精确的随意运动。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using

18、single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的生理病理基础痉挛的生理病理基础 牵张反射：牵张反射： 是指肌肉受到牵拉后肌肉出现反射性是指肌肉受到牵拉后肌肉出现反射性收缩。牵张反射是脊髓反射，脊髓在失去高级神收缩。牵张反射是脊髓反射，脊髓在失去高级神经中枢控制后，牵张反射增强。从大脑皮质到脊经中枢控制

19、后，牵张反射增强。从大脑皮质到脊髓的任何上运动神经元发生损伤都可能出现痉挛，髓的任何上运动神经元发生损伤都可能出现痉挛，但痉挛的性质依损伤的部位不同而异，如皮质或但痉挛的性质依损伤的部位不同而异，如皮质或内囊病变时，皮质对运动的下行抑制作用丧失，内囊病变时，皮质对运动的下行抑制作用丧失，而脑干脊髓束对运动的下行指令可能异常活跃，而脑干脊髓束对运动的下行指令可能异常活跃，牵张反射增强。若脊髓颈段受到横断性伤害时，牵张反射增强。若脊髓颈段受到横断性伤害时，通路该处的各条通路对运动的控制作用全部丧失，通路该处的各条通路对运动的控制作用全部丧失，运动神经元对外周的敏感性增高，均可导致牵张运动神经元对外

20、周的敏感性增高，均可导致牵张反射增强，引起痉挛。反射增强，引起痉挛。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the s

21、ystem are AT89C51 microcontroller and DS18B20 temperature sensor. 牵张反射（stretch reflex）：人和动物的躯体运动和姿势维持受神经系统调控，其基本机制之一就是牵张反射，它是指骨骼肌在受到外力牵拉时引起受牵拉的同一肌肉收缩的反射活动。牵张反射的反射弧为：感受器（肌梭、腱梭）传入神经中枢（脊髓前角a运动神经元） 传出神经效应器（同一肌肉的梭外肌）。牵张反射有腱反射和肌紧张两种类型。This paper mainly introduces the design of an intelligent temperature c

22、ontrol system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design

23、of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Ia/IIIb -

24、s -dThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontrol

25、ler and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the

26、system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomput

27、er. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的评定痉挛的评定 1改良改良Ashworth分级法分级法 ：是临床上评定痉：是临床上评定痉挛的主要方法。手法检查是检查者根据受挛的主要方法。手法检查是检查者根据受试者关节被动运动时所感受的阻力来进行试者关节被动运动时所感受的阻力来进行分级评定（分级评定（1末，末，+半，半，2大，大，3全，全，4僵）。僵）。2. 生物力学评定方法生物力学评定方法 包括钟摆试验和等速包括钟摆试验和等速装置评定方法。装置

28、评定方法。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontro

29、ller and DS18B20 temperature sensor. ClonusClonus分级分级 0 0 无踝阵挛无踝阵挛 1 1 踝阵挛持续踝阵挛持续1-4s1-4s 2 2 持续持续5-9s5-9s 3 3 持续持续10-14s10-14s 4 4 持续持续15s15s痉挛的评定痉挛的评定This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and cont

30、rol by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 1、治疗目的、治疗目的 ：缓解肌痉挛，提高或恢复患：缓解肌痉挛，提高或恢复患者的运动能力和日常生活活动能力。者的运动能力和日常生活活动能力。This paper mainly introduces the des

31、ign of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗

32、痉挛的治疗 2. 治疗方法治疗方法(1) 解除诱因解除诱因 ：一些痉挛与各种外界刺激有关，：一些痉挛与各种外界刺激有关，因此在治疗前要尽量消除诱发肌痉挛的因素，如因此在治疗前要尽量消除诱发肌痉挛的因素，如发热、结石、尿路感染、压疮、疼痛、便秘和加发热、结石、尿路感染、压疮、疼痛、便秘和加重肌痉挛的药物等。通常诱因解除后，肌痉挛会重肌痉挛的药物等。通常诱因解除后，肌痉挛会有明显减轻。有明显减轻。This paper mainly introduces the design of an intelligent temperature control system which realizes th

33、e function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 2. 治疗方法治疗方法 (2) 姿势和体位姿势和体位 ：某些姿势和体位可减轻肌痉挛。：某些姿势和体位可减轻肌痉挛。患者应

34、从急性期开始采取抗痉挛的良姿体位，可患者应从急性期开始采取抗痉挛的良姿体位，可使异常增高的肌张力得到抑制，如脑血管意外、使异常增高的肌张力得到抑制，如脑血管意外、颅脑外伤的急性期采取卧位抗痉挛模式体位，可颅脑外伤的急性期采取卧位抗痉挛模式体位，可减轻肌痉挛；脊髓损伤患者利用斜板床站立，也减轻肌痉挛；脊髓损伤患者利用斜板床站立，也可减轻下肢肌痉挛。脑瘫患儿的正确抱姿等。可减轻下肢肌痉挛。脑瘫患儿的正确抱姿等。This paper mainly introduces the design of an intelligent temperature control system which real

35、izes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （3）物理治疗）物理治疗 1）冷疗法）冷疗法 ：用冰敷或冰水浸泡痉挛肢体：用冰敷或冰水浸泡痉挛肢体510s

36、，可使肌痉挛产生一过性放松。可使肌痉挛产生一过性放松。 2）水疗：）水疗： 水压对肌肉持久的压迫与按摩有利于水压对肌肉持久的压迫与按摩有利于肌痉挛的缓解。室温保持在肌痉挛的缓解。室温保持在25 ，水温宜在，水温宜在30左右。左右。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital tempe

37、rature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （3）物理治疗）物理治疗 3）温热疗法）温热疗法 ：各种传导热（如蜡、砂、泥等）、：各种传导热（如蜡、砂、泥等）、辐射热（红外线）及内生热（超短波）辐射热（红外线）及内生热（超短波）4）痉挛肌及其对抗肌的交替电刺激疗法：）痉挛肌及其对抗肌的交替电刺激疗法： 是将是将波宽和频率相同，但出

38、现的时间有先、后的两组波宽和频率相同，但出现的时间有先、后的两组方波，分别刺激痉挛肌及其拮抗肌，使两者交替方波，分别刺激痉挛肌及其拮抗肌，使两者交替收缩，利用交互抑制和高尔基腱器兴奋引起的抑收缩，利用交互抑制和高尔基腱器兴奋引起的抑制，以对抗痉挛。制，以对抗痉挛。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single

39、bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.23低频脉冲低频脉冲痉挛肌及其拮抗肌交替电刺激疗法痉挛肌及其拮抗肌交替电刺激疗法 利用两组脉冲电流，利用两组脉冲电流，先后分别刺激痉挛肌先后分别刺激痉挛肌和拮抗肌肌腹和拮抗肌肌腹，以达到，以达到松弛痉挛肌松弛痉挛肌的治疗的治疗方法。方法。 刺激痉挛肌，张力感受器兴奋，刺激痉

40、挛肌，张力感受器兴奋，反射性抑制痉反射性抑制痉挛挛； 刺激拮抗肌，通过刺激拮抗肌，通过交互抑制交互抑制，使痉挛肌松弛。，使痉挛肌松弛。 适应证：适应证：痉挛性瘫痪痉挛性瘫痪、帕金森病等。、帕金森病等。 禁忌证：禁忌证：肌萎缩侧索硬化症、多发性硬化肌萎缩侧索硬化症、多发性硬化进展期等。进展期等。 拮抗肌拮抗肌痉挛肌痉挛肌28/85This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measure

41、ment and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the

42、function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （4）运动治疗：）运动治疗： 运动疗法包括主动运动、被运动疗法包括主动运动、被动运动和按摩等手法治疗。动运动和按摩等手法治疗

43、。 主动运动痉挛肌的拮抗肌，产生交互性抑主动运动痉挛肌的拮抗肌，产生交互性抑制作降低肌痉挛。如肱二头肌痉挛可练习肱三制作降低肌痉挛。如肱二头肌痉挛可练习肱三头肌的主动和抗阻收缩；头肌的主动和抗阻收缩； 被动运动时也可结合某些反射机制来降低被动运动时也可结合某些反射机制来降低肌张力，如被动屈曲足趾可降低肌张力；肌张力，如被动屈曲足趾可降低肌张力； 深而持久的肌肉按摩，或温和地被动牵张深而持久的肌肉按摩，或温和地被动牵张痉挛肌，可降低肌张力。痉挛肌，可降低肌张力。This paper mainly introduces the design of an intelligent temperatur

44、e control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （5）抑制异常反射性模式）抑制异常反射性模式 ：应用

45、各种神经：应用各种神经发育治疗技术对患侧肢体出现的不同程度发育治疗技术对患侧肢体出现的不同程度的异常反射性模式进行抑制，可缓解痉挛。的异常反射性模式进行抑制，可缓解痉挛。如对于脑血管意外患者出现的痉挛，可通如对于脑血管意外患者出现的痉挛，可通过过Bobath技术、技术、Rood技术以及技术以及PNF技术抑制技术抑制痉挛模式，调整肌张力，以建立正确的姿痉挛模式，调整肌张力，以建立正确的姿势模式和功能活动模式。势模式和功能活动模式。This paper mainly introduces the design of an intelligent temperature control system

46、 which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （6）肌电生物反馈：）肌电生物反馈： 可减少静止时肌痉挛可减少静止时肌痉挛及其相关反

47、应，也可抑制被动牵伸时痉挛及其相关反应，也可抑制被动牵伸时痉挛肌的不自主活动。利用肌电生物反馈再训肌的不自主活动。利用肌电生物反馈再训练痉挛肌的拮抗肌，也能起到交替抑制的练痉挛肌的拮抗肌，也能起到交替抑制的作用。作用。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature

48、 sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （7） 矫形器的应用：矫形器的应用： 可利用上肢或下肢可利用上肢或下肢矫形器矫正痉挛。如用于内收肌痉挛的外矫形器矫正痉挛。如用于内收肌痉挛的外展矫形器，用于屈肘肌痉挛的充气压力矫展矫形器，用于屈肘肌痉挛的充气压力矫形器，用于足下垂内外翻的踝足矫形器等。形器，用于足下垂内外翻的踝足矫形器等。其作用除

49、了能防止肌痉挛的加重外，还能其作用除了能防止肌痉挛的加重外，还能防止挛缩，应早期积极采用。防止挛缩，应早期积极采用。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The

50、core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痉挛的治疗痉挛的治疗 （8）药物治疗：）药物治疗： Dantrolene 硝苯呋海因（丹曲林）：原硝苯呋海因（丹曲林）：原理是梭内外肌肌肉细胞膜抑制（干扰钙从理是梭内外肌肌肉细胞膜抑制（干扰钙从肌浆网释放唯一的外周制剂）。用法为肌浆网释放唯一的外周制剂）。用法为25mg Bid，每周增加，每周增加25-50mg，最大剂量，最大剂量200-400mg/d。副作用有无力、头晕、胃肠。副作用有无力、头晕、胃肠道反应、肝脏损害