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中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China)

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中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China)中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China) 中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China) Opportunities and challenges of rehabilitation medicine in China - Rehabilitation Medicine Sou...

中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China)
中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China) 中国康复医学发展的机遇与挑战(Opportunities and challenges of rehabilitation medicine in China) Opportunities and challenges of rehabilitation medicine in China - Rehabilitation Medicine Source: [Abstract] the Sichuan earthquake has catalyzed the development of rehabilitation medical service in China, and the medical system reform has provided the stage for this. This paper analyzes the current development of rehabilitation medicine is facing opportunities and challenges, the association of rehabilitation medicine and health care, medical rehabilitation construction and rehabilitation education, as well as the development of rehabilitation; the brief introduction of the development of new technology and its influence to the medical rehabilitation, including motion feedback, motion control, motion analysis, brain function, rehabilitation robots, rehabilitation engineering, stem cells and application of China traditional rehabilitation treatment technology etc.. Keywords rehabilitation medicine; technology; development; Since the Wenchuan earthquake in 2008, the development of rehabilitation medicine in China is facing unprecedented opportunities as well as major challenges. This paper analyzes the opportunities and challenges we are facing. 1, the opportunities for Discipline Development 1.1. The rehabilitation of the wounded in the Wenchuan earthquake, the large medical treatment, the great transfer and the great rehabilitation, completed in the Wenchuan earthquake have become the model of medical treatment for the international natural disasters. In June 2008 the Ministry of health minister Chen Zhu convened a special meeting in Chengdu earthquake rehabilitation, the rehabilitation of the wounded in earthquake as a priority among priorities, to immediately catch, immediately catch, grasp now, started the prelude to large-scale earthquake rehabilitation work. Since then, the Ministry of health and the CDPF, as well as local governments at various levels, have issued a series of codes and standards for the rehabilitation of earthquake victims. Rehabilitation medical workers throughout the country have carried out early rehabilitation of the wounded in hospitals throughout the country. After a large number of the wounded returned to Sichuan, the Chinese Rehabilitation Medical Association actively cooperated with the Ministry of health and organized the national earthquake rehabilitation medical team to Sichuan, thus ensuring the rehabilitation of the large number of earthquake wounded. The leaders of the State Council have also written instructions for the development of rehabilitation medical service. The earthquake recovery inspired the government and the public for the rehabilitation of medical attention, contributed to the Hong Kong Rehabilitation Center, Bayi rehabilitation center and rehabilitation center of West China Hospital of the start of the project, but also to promote a large number of domestic and foreign charities into rehabilitation medical aid project. Since then, the head of the Ministry of health has suggested that rehabilitation medical care is a short board of our medical system, and is an important content that can not be ignored in the perfection of the national medical system. This lays the foundation for the development of rehabilitation medical service in the future. 1.2 medical system reform, the State Council promulgated the national medical system reform program in April 2009. In the new medical reform plan, the main points related to rehabilitation medicine are: emphasizing the prevention, treatment and rehabilitation, and confirming the status of rehabilitation medical treatment. Rehabilitation medicine, as one of the four pillars of modern medicine defined by WHO, can be formally recognized in the medical reform document of our country. It is a new milestone in the development of rehabilitation medicine in the future. Confirm the separation of medicine and highlight the value of rehabilitation medical treatment. Although the social value and benefits of medical rehabilitation to be recognized by the society, but our hospital not hit the blood holmium solution Jing became her all the small tan Gou Ren Qiu Dao in silk sled saliva scrambling and wood?, which limits the positive development of hospital medical rehabilitation work. And after the separation of medicine, rehabilitation medical service as a project characterized by medical technology services, its economic value will be highlighted. Starting the doctor's practice of multi-point practice is helpful to solve the problem of the lack of high-level talents in rehabilitation medical service. The development of rehabilitation medicine in China started late, and the limited personnel at high level, which is the bottleneck of the rapid development of rehabilitation medicine. Once more practice can be implemented, China's Limited rehabilitation of high-level talent resources can be released, thus greatly promoting the development of rehabilitation medicine in china. Clear the basic medical attributes of rehabilitation treatment, rehabilitation into medical insurance is just around the corner. The past medical rehabilitation was mistaken for Holmium Zha Ge seed belong to shout at?, belongs to the high level medical service, thus excluded from the basic medical outside. The document proposes that rehabilitation medicine belongs to basic medical care, which provides an important basis for rehabilitation medical care. Affirmation of undergraduate and junior college education strategies, Helps rehabilitation therapists develop their academic education. Since our country since 2001 officially started rehabilitation therapists education rapid development, currently offering rehabilitation universities in more than 70, more than 100 colleges and universities; master's and doctoral education is booming. Nevertheless, compared with the gap of the 300 thousand therapists in China, the education scale is still very small. National Accreditation of tertiary and undergraduate education will help promote the development of rehabilitation therapists' academic qualifications. In addition, continuing education projects are growing very fast, and rehabilitation specialist training is gradually moving towards the right track. Rehabilitation education is the basic component of the talent strategy of rehabilitation medicine, and it is the focus of attention at present. To encourage the development of private hospitals, provide policy support for the development of the rehabilitation hospital. The development of rehabilitation hospitals in China is very weak, but the government is not investing enough in this direction. Private capital into the rehabilitation hospital, will be extremely conducive to the enrichment of this weak link. 1.3 rehabilitation insurance, under the leadership of the State Council concerned, rehabilitation medical care into health care has been included in the work schedule of government departments. Rehabilitation has entered the medical insurance projects and models have been carried out several expert proof, the basic consensus has been formed. At present, a few areas of the medical insurance system will be part or all of rehabilitation medicine, but most areas of rehabilitation medical programs have been excluded. Rehabilitation medical insurance will greatly promote the development of rehabilitation services throughout the country, and will benefit tens of millions of disabled and disabled patients. Investigation on the status of general hospital 1.4 Rehabilitation Medicine Department of rehabilitation medicine, and capacity building in the rehabilitation hospital in the Moh's auspices, has been basically completed. The goal is to determine the current situation of rehabilitation medicine in national general hospitals, and to formulate policies, policies and methods for strengthening the rehabilitation medical capacity construction. Therefore, the ability construction of rehabilitation medicine will be a hot spot. Under the guidance of this policy, some international aid projects are also aimed at capacity-building in rehabilitation medicine. The construction of rehabilitation medicine includes personnel training, Department equipment / facilities and rehabilitation medical management. Among them, the training of personnel is the most important link. 1.5, industrial injury rehabilitation, industrial injury rehabilitation as a special type of medical insurance category, in recent years has made outstanding progress. In particular, the standard of rehabilitation medical institutions and the construction of institutions will be improved, which will provide important information and experience for the rehabilitation of medical services in other areas of china. The development of industrial injury rehabilitation takes the lead in practice and integrates rehabilitation medicine into our medical insurance system. 2 the challenges we face 2.1 earthquake victims long-term rehabilitation of earthquake victims rehabilitation has made great achievements, but in Sichuan there are a considerable number of the wounded need further medical rehabilitation, the relevant policy still needs to be improved, local technical staff rehabilitation professional ability and level needs to be improved and strengthened. In addition, there are a large number of wounded in need of community rehabilitation and re employment, the emergence of a large number of children and adolescents wounded in the development process there are many new problems, nearly 500 amputees relates to prosthetic replacement, hundreds of spinal cord injury patients need long-term solutions, prevention of complications, self-care, aid application and employment, many nonunion malunion and the wounded will face to enter the ranks of the problem or rehabilitation of disabled people. The long-term rehabilitation of the wounded in the earthquake will continue to be a priority in the coming years. How to solve properly is a challenge for all of us. 2.2 healthcare reform although tentative, implementation and enforcement is still great difficulty. Rehabilitation medicine in various hospitals is not high, weak equipment and settings, lack of talent. Although the situation is favorable, the development of the discipline still takes time. Although the separation of medicine will help to highlight the value of rehabilitation, the total proportion of rehabilitation medicine in hospitals is very low and it is difficult to perform well in the short term. The doctor has more practice to break the ice, but the real solution to the flow of talent, still need to each hospital policy, to be the concept of rehabilitation professional and technical personnel changes. Rehabilitation therapists education syllabus and teachers rush on like a swarm of hornets, / / teaching practice are very weak. The rapid reversal of this situation is very important for the healthy development of rehabilitation and education. In addition, the practice qualification of rehabilitation therapists has not yet formed. Rehabilitation specialist training has been in operation for many years, but it is still a long way from the country. The development of rehabilitation hospitals is still restricted by policies and funds. The development of rehabilitation hospitals in China is very weak, but the government is not investing enough in this direction. Private capital into the rehabilitation hospital, will be extremely conducive to the enrichment of this weak link. 2.3, rehabilitation insurance and international function, disability and health classification, rehabilitation medical insurance into health care has been basically a foregone conclusion, but how to formulate evaluation criteria and the choice of what tools will be the biggest challenge. ICF is the second dictionary of the WHO. It is the common language and tool for all countries in the world to carry out the relevant functions, disability and health problems. The core combination is used as a basic tool for clinical and research evaluation and health care under specific health issues and specific circumstances. The core group ICF has been confirmed in 12 health conditions including: chronic systemic pain, back pain, osteoarthritis, osteoporosis, rheumatoid arthritis, chronic ischemic heart disease, diabetes, obesity, obstructive pulmonary disease, depression, stroke, breast cancer. The application of ICF in China will be gradually popularized in 2009. How to carry out ICF standardization of many diseases and how to apply it in our medical insurance is a challenge that we all have to face. 2.4 rehabilitation medical technology challenges 2.4.1 motion control refers to the movement organ (muscle, bone, blood vessels and nerves) the basic integrity of the case, to complete the function of specific sports / activities were unable to control the action is accurate and targeted. Motor control disorders are one of the most common problems of neurological disorders. The evaluation and training of motion control has become the focus of attention. The related basic theories and clinical practice research will be the hot spot in the next 5~10 years. 2.4.2 motion feedback motor feedback refers to the way a patient understands his or her motor state. Posture mirror is the most typical mode of motor feedback. The motion feedback is divided into forward feed and back feed. Motion feedback is the basic performance requirement of new sports training equipment, and it is also one of the key links to improve the level of sports training. Motor feedback training is the basis for the treatment of neural remodeling. At present, the most notable sports feedback training equipment includes virtual scene training system, dynamic balance training system and intelligent movement control training system. The development of 2.4.3 rehabilitation engineering tends to be highly intelligent, highly practical and mechanical and electrical integration. Its advances include materials science, ergonomics and Bioengineering, electronics, etc.. Among them, the development of more prominent new directions include: new prostheses / orthoses, user-friendly rehabilitation aids, environmental adaptation system, personalized wheelchair. The combination of rehabilitation engineering with cellular and molecular biology is also remarkable, including molecular biological scaffolds, micro robots, organ and tissue repair, reconstruction materials and scaffolds. 2.4.4 stem cell stem cell research is a hot topic in the twenty-first Century, and is no exception in the field of rehabilitation medicine. The application of stem cells involves not only the engraftment, proliferation and control of stem cells, but also the role of motor or functional movements in the differentiation of stem cells. With the rapid development of stem cell research and application, great attention should be paid to the significant impact of functional movement training on stem cell progression. 2.4.5 rehabilitation robot rehabilitation robot is the fastest growing equipment in the twenty-first Century. Application of rehabilitation robot is to use the principle of the robot, auxiliary or substitute the function of patients, or remote rehabilitation training, repeated thousands of times in order to achieve the standardization action, promote the nerve remodeling, to restore the motion and motion control ability of patients. Rehabilitation robots need to meet the following requirements: emphasize the function / practical action, feedback image to give patients action, you can set the action / control difficulty, active / passive power / motor function, action completion status records / comparison, quantitative / qualitative action can be repeated, there is a reasonable interest and is safe and convenient to use. At present, rehabilitation robots have been commercialized and are entering the Chinese market. 2.4.6 motion analysis refers to the quantitative or qualitative detection of the state of human motion. Traditional methods include two-dimensional or three-dimensional camera analysis (infrared photography or ordinary camera mode), and its computer analysis system has been basically achieved real-time data acquisition and rapid analysis. New methods of analysis include ultrasonic detection and analysis, gyroscope pose detection and analysis, joint angle meter detection and analysis, pressure carpet analysis (time / space parameters), plantar pressure analysis, etc.. Dynamic electromyography and gas metabolism have become the basic components of exercise analysis. The clinical application and scientific research of motion analysis in China have been gradually popularized, and will be gradually popularized in the next 5~10 years. 2.4.7's advanced brain function involves speech, cognition, behavior, motor control and so on. It is one of the most important problems in neurological rehabilitation. The restoration of advanced brain function is one of the prerequisites for rehabilitation. With the development of functional MRI, positron emission tomography (PET) and event-related potentials (ERP), the study of advanced brain function has been deepened. ERP is known as Juan Zhu may well have ho beans by the Piao Ao delta thumb?, a part of that applied specific stimulation of sensory systems in the brain or the potential change in brain regions. The study of related brain advanced functions will be a combination of the field of rehabilitation medicine and neuroscience. 2.4.8 traditional Chinese rehabilitation medicine and traditional Chinese medicine play a very important role in rehabilitation medicine. Acupuncture and Chinese medicine have gradually influenced the world. China Qigong keep the most fashionable and modern rehabilitation technology at the Jiao Chan Chan ho Bo Shuo and ye plutonium plant?, are with the idea of the movement to promote the recovery of motor function of the body. China traditional medicine overall concept, diagnosis and treatment of the dialectical thinking mode and Zai my bed at Jing ho female is Guo Jie Jiao flail halo tanning's postscript shank. P 6 -- min Jie Jiao very tanned Mu Lan under the jurisdiction of certain potential mortar can change construction downtown, that point? Professional services to provide preventive medicine thesis services, and provide a large number of papers, information, such as business needs, please consult the web site customer service staff! [References] [1] analysis of casualties in Xu Peiqing 1 earthquake [J] 1 Journal of Chinese hospital management, 1994, 10 (5): 3111 [2] Luo Fei, Wang Xuquan, Zhou Qiang, et al. Principles of treatment of wounded ladder in 1 Wenchuan earthquake [J]. 1 Chinese Journal of trauma, 2008, 24 (5): 58325861 [3] Sun Zhigang and Li Hongli. Methods and principles for classification of the wounded in the 1 earthquake [J]1, disaster science, 2001, 16 (1): 612641 [4] characteristics and trauma 1 Zhengguo earthquake disaster treatment [J]1 Chinese Journal of trauma, 2008, 24 (4): 40124041 [5]: Zheng Shangwei stone, 1 Regional State-level Hospital in Wenchuan Earthquake medical rescue in the strategic support role [J]1 Chinese evidence-based medical journal, 2008, 8 (3): 38023821
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