Sequelae of Polio
Introduction
Introduction to sequelae of polio The sequelae of polio is a virus that invades the anterior horn of the spinal cord, the motor nerve center, and the late torso and extremities deformed. In recent years, polio has been significantly reduced due to the importance of prevention, and it is occasionally scattered in rural areas. basic knowledge The proportion of illness: 0.001% Susceptible people: children under 5 years old Mode of infection: infection in the gastrointestinal tract and respiratory tract Complications: high arch foot
Cause
Causes of polio sequelae
Virus infection (30%):
Poliovirus infection, the virus mainly invades the motor nerves of the gray matter after the onset, the nerve cells in the central area are necrotic, and the inflammatory infiltration and edema around the central area lead to the corresponding peripheral nerve spasm. In severe cases, the child dies in the acute phase; the lighter, the trunk and the limbs are deformed, so it is called the sequelae of the baby.
Prevention
Polio sequela prevention
1. The isolated patient is isolated for at least 40 days from the date of onset. The first week should emphasize the isolation of the respiratory tract and the intestine. The excretion should be blocked and disinfected with 20% bleaching powder. The utensils should be immersed in 0.1% bleaching powder clarification solution or boiled for disinfection, or exposed to sunlight for two days. The ground is disinfected with lime water. Soak your hands in 0.1% bleaching solution or disinfect with 0.1% peracetic acid. For those who are in close contact, you should observe for 20 days.
2. It is very important to do a good job in daily hygiene, to improve environmental sanitation, to eliminate flies, and to cultivate health habits. During the epidemic, children should be less likely to go to crowded places to avoid excessive fatigue and cold, delaying various preventive injections and unneeded surgery, so as not to cause the frustration infection to become a sputum type.
Complication
Polio sequelae complications Complications
(1) Water and electrolyte disorders: Patients with respiratory muscle spas often cause water and electrolyte disturbances when using artificial respirators for a long time. High fever, sweating, vomiting, diarrhea, inability to eat, and changes in blood gases can cause severe biochemical disorders. Excessive fluid replacement can cause edema and hyponatremia.
(2) Myocarditis: The virus can directly invade the myocardium, causing changes in the T wave, ST segment and PR interval of the ECG, which are seen in 10% to 20% of cases.
(3) Hypertension: can be caused by the following factors: 1 hypoxia, 2 due to the involvement of the inferior colliculus, leading to persistent hypertension, which in turn causes retinopathy, convulsions and changes in consciousness.
(4) pulmonary edema and shock: the pathogenesis is unknown, often at the end of the death case.
(5) Digestive tract perforation and hemorrhage: acute dilatation of the stomach and duodenum, cecal perforation, duodenum, acute ulcer of the stomach and esophagus, multiple erosion of the entire gastrointestinal tract accompanied by major bleeding and intestinal Paralysis and so on.
Symptom
Symptoms of sequelae of poliomyelitis Common symptoms Coronary contracture of the clubfoot, adolescent scoliosis, hip flexion and external rotation, spinal cord hemisection syndrome, spinal cord infiltration, spinal cord, anterior horn occlusion
The incubation period is 3 to 35 days, generally 7 to 14 days. Clinically, it can be divided into four types: asymptomatic, frustrated, sputum-free and sputum-type.
1, asymptomatic (ie, latent infection): accounted for 90% to 95% of all infected. It is asymptomatic after infection, but the virus can be isolated from the pharynx and feces, and a 4-fold increase in specific neutralizing antibodies can be detected in duplicate sera separated by 2 to 4 weeks.
2, frustrated: about 4% to 8% of all infected people. Clinical manifestations of fever, fatigue, headache, lethargy, sore throat, nausea, vomiting, constipation and other symptoms, without the symptoms of central nervous system involvement.
Examine
Examination of sequelae of polio
1. Blood routine: The total number of white blood cells and the percentage of neutrophils are mostly normal. The number of white blood cells in a few patients is slightly increased, (10-15)×109/L, and the percentage of neutrophils is also slightly increased. The erythrocyte sedimentation rate increased in 1/3 to 1/2 patients.
2, cerebrospinal fluid examination: cerebrospinal fluid in the prodromal period is generally normal, the number of cells in the pre-temporal period often increases, usually between (50 ~ 500) × 106 / L, even the percentage of neutrophils may increase, but later lymphocytes Mainly. Proteins can be normal at an early stage, gradually increasing later, chlorides are normal, and sugars are normal or slightly elevated.
Diagnosis
Diagnosis and diagnosis of sequelae of polio
1. Frustrated type: It should be differentiated from upper respiratory tract infection caused by influenza and other viruses. Identification can be based on epidemiological data in conjunction with laboratory tests, particularly as a result of virus isolation from the pharynx.
2, innocent type: should be combined with other viruses (coxsackie virus, echovirus, EB virus, mumps virus, lymphocytic choriomeningitis virus, epidemic encephalitis virus) caused by meninges Identification of inflammation, purulent meningitis, tuberculous meningitis, fungal meningitis, and meningococcal leptospirosis.
