麻风病患者的神经学评估和残疾程度:诊断和出院时的观察

C. Pires, S. Bandeira, Gabriela Ferreira Rocha, Marcella Silva Maia, A. Nascimento, Márcia Moraes dos Prazeres, Suzana Maria Klautau Ferreira, Anderson Phelipe Dias Sabry Azar, Heraldo Hebert Mauro Neto, R. O. Chaves, Adriana Kamilly Leitão Pitman Machado
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摘要

背景:照顾麻风病患者需要进行神经系统评估,以预防潜在的身体残疾。这项研究的重点是帕拉州大学皮肤科麻风病患者在诊断和出院时的神经损伤和身体丧失能力程度。方法和发现:这是一项横断面观察性研究,基于2012年至2016年间转诊服务中14名患者的医疗记录、神经系统评估和DI,应用描述性统计分析。在诊断时,观察到患者的第五指外展力下降(14.28%),拇趾伸展和足背屈(10.72%);尺神经区(3.57%)和胫神经区(25%)保护敏感性丧失;尺神经增厚7.15%;DI 0(64.28%)和DI 1(35.72%)。出院时,10.72%的患者第5指外展、拇趾伸展和足背屈减少(14.28%);仅在胫神经区失去保护敏感性(17.87%);尺神经增厚4.28%;DI 0(78.57%)和DI 1(21.43%)。结论:因此,除腓神经外,大多数患者在这两个时刻的神经功能评估和DI 0均正常,放电改变减少。因此,它强调了卫生小组的主要作用,卫生小组是健康教育的主要推动者之一,尤其是在预防麻风病残疾方面。
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Neurological assessment and degree of disability of leprosy patients: observation at diagnosis and at discharge
Background: Caring for leprosy patients requires neurological assessment for prevention of potential physical disabilities. This study focused on the neurological impairment and degree of physical incapacity (DI) at the time of the diagnosis and at discharge of leprosy patients from Dermatology Department of the University of the State of Pará. Methods and findings: It was a cross-sectional, observational study based on the medical records, neurological assessment and DI of 14 patients assisted at a referral service between 2012 and 2016, applying descriptive statistical analysis. At diagnosis were observed patients with decreased abduction forces of the 5th finger (14.28%), extension of hallux and foot dorsiflexion (10.72%); loss of protective sensitivity in the ulnar nerve area (3.57%) and tibial nerve area (25%); 7.15% of thickened ulnar nerve; DI 0 (64.28%) and DI 1 (35.72%). At discharge, 10.72% of the patients showed decreased abduction of the 5th finger, extension of hallux and foot dorsiflexion (14.28%); loss of protective sensitivity just in the tibial nerve area (17.87%); 4.28% of thickened ulnar nerve; DI 0 (78.57%) and DI 1 (21.43%). Conclusions: Therefore, most of the patients had normal neurological assessment and DI 0 at both moments, with reduction of alterations in discharge, except for the fibular nerve. Thus, it is highlighted the primary role of the health team, which constitutes one of the main agents promoters of health education, especially when it comes to preventing disabilities in leprosy.
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