Какво е лечението на миелит?

Because I don't know what myelitis is, I have these in a general way, I don't know if I can help you! Treatment measures for myelitis 1. In the early stage, use hydrocortisone 100-200 mg or dexamethasone 5-10 mg intravenously, once a day, and after 7-10 days, if the condition is stable, change to prednisone 30 mg orally. The dose can be gradually reduced as the condition improves. 2. 250ml of 20 percent mannitol was intravenously infused once a day for dehydration, and 500ml of 706-generation plasma was intravenously infused once a day to improve the spinal cord microcirculation. 3, to give large doses of vitamin B family preparations and citicoline and other neurotrophic drugs. 4. Proper selection of antibiotics to prevent respiratory and urinary tract infections. 5. Regularly turn over and pat the back to prevent bedsores. Strengthen the functional exercise of the affected limbs to prevent limb deformities. Acute myelitis is an acute onset inflammatory disease of the spinal cord. The lesions often occur in the thoracic spinal cord. If the lesions only invade the gray and white matter of several segments of the spinal cord, it is called transverse myelitis, and if the lesions continue to develop upward, it is called ascending myelitis. The exact cause is not very clear, it may be caused by viral infection or the body's autoimmune response after viral infection. There are also a small number of patients who become ill after vaccination. Trauma and excessive fatigue can be the predisposing factors of this disease. Myelitis is more common in young and middle-aged men and can occur in any season, but is more common in spring and winter. Most patients have a history of upper respiratory tract infection 1 to 3 weeks before the onset of myelitis, such as fever, cough, body aches and other symptoms. Symptoms of myelitis often come on suddenly, often preceded by chest, back or abdominal pain, and a girdle feeling (as if there is a tight band around the body). Weakness in both lower extremities, difficulty walking, and progress to complete paralysis within hours or days. At the same time, numbness was also felt in both lower extremities, and the skin sensation below the level of the spinal cord lesions decreased or disappeared. And accompanied by bladder and bowel dysfunction, urinary retention or incontinence. Below the level of the lesion segment, there is no or little sweating of the skin, paleness, dryness, and brittle toenails. If the cervical spinal cord is also damaged, the upper and lower limbs can be paralyzed, and even breathing difficulties can occur. This is because the respiratory muscles are also paralyzed after the high cervical spinal cord is involved. This is a very serious situation and the patient should be transported to the hospital immediately. Paralyzed limbs are flaccid paralysis in the early stage of the disease process, also known as flaccid paralysis. At this time, the muscle tension of the limbs is reduced and the tendon reflexes disappear. After 1 to 3 weeks, it gradually transformed into spastic paralysis, also known as hard paralysis, with increased muscle tone, hyperreflexia, and positive Babinski sign of pathological reflex. After proper treatment, the patients have passed the acute phase, and the muscle strength of the paralyzed limbs of most patients can be gradually recovered, and about half of the patients can stand and walk within a few months after the illness. Laboratory examination can find that the white blood cell count is normal or slightly increased, the lumbar puncture and neck compression test shows that the spinal canal is unobstructed, the number of cells and protein content in the cerebrospinal fluid are normal or slightly increased, and the increased cells are mainly lymphocytes, sugar and chloride. The content is normal. Spine X-ray showed normal. According to the above clinical characteristics, the diagnosis is not difficult, but there are also some neurological diseases such as acute infectious polyneuritis, epidural abscess, spinal tuberculosis, etc., which are sometimes easily confused with acute myelitis, and need to be carefully identified by a doctor. How should patients with acute myelitis be treated? First of all, care should be taken seriously, because the patient's limbs are paralyzed, lying in bed all day, unable to turn over by himself, and the buttocks are prone to bedsores, so they need good care. The patient should be turned over frequently, and the bedding should be kept clean and soft. If there is a voiding disorder, catheterization is required, preferably with retention. And apply 0.02 percent nitrofurazone solution to flush the bladder, 100 ml each time, once every 4 to 6 hours. After putting in the above washing solution, keep it for 30 minutes before releasing it, and then clamp the drainage tube to keep a certain capacity in the bladder and prevent the occurrence of spastic small bladder. Because the patient's limbs are neither able to move autonomously and often feel lost, scalding should be prevented. For patients with long-term paralysis of limbs, the foot is prone to foot drop due to frequent compression of the quilt. Therefore, a guard should be placed on the foot. In terms of drug treatment, in the acute phase, adrenal cortex hormones plus hydrocortisone 200 mg or dexamethasone 10 mg can be given intravenously in glucose water, once a day for 7 to 10 consecutive days, and later can be changed to strong pine orally. B vitamins, dibazole and nerve cell activators can be used. In addition, traditional Chinese medicine can be applied, and heat-clearing and detoxifying drugs can be given in the acute stage, such as Yinhua, Qiao, Banlangen, Daqingye, Scutellaria, Anemarrhena, Alisma, raw licorice, Achyranthes, etc. If the respiratory muscles are paralyzed and breathing is difficult, artificial respiration should be given to keep the airway open, and tracheotomy should be performed if necessary. Attention should also be paid to the treatment of comorbidities, such as bedsores, urinary tract infections, and respiratory tract infections. Physical therapy and acupuncture are very helpful to promote the recovery of paralyzed limbs. In the early stage of the disease, massage and passively exercise the paralyzed limbs to improve blood circulation and prevent muscle atrophy. When muscle strength has recovered, patients should be encouraged to do active exercise within their ability. , to promote muscle strength to return to normal as soon as possible.

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