[{"data":1,"prerenderedAt":1765},["ShallowReactive",2],{"\u002Fblog\u002FPNI":3,"post-count":440,"series-global-data":441,"authors-all":606,"series-sidebar-神經物治剩餘章節":802},{"id":4,"title":5,"author":6,"body":7,"date":427,"description":428,"draft":429,"edited_at":427,"extension":430,"featured_image":431,"meta":432,"navigation":433,"path":434,"pinned":429,"seo":435,"sitemap":436,"stem":437,"tags":438,"__hash__":439},"blog\u002Fblog\u002FPNI.md","PNI","hibiki12141132",{"type":8,"value":9,"toc":423},"minimark",[10,14,17,20,23,26,44,47,123,126,129,150,153,181,188,191,200,203,214,217,220,229,237,240,251,253,256,312,315,323,326,328,331,394,397],[11,12,13],"p",{},"原因可能為外傷或急性拉傷",[11,15,16],{},"可能會造成感覺功能喪失，運動功能喪失，抑或者兩者都喪失",[11,18,19],{},"可能造成脫髓鞘或軸突退化",[11,21,22],{},"髓鞘再生，或軸突再生，或感覺受器、肌肉運動終板或兩者的神經再支配，才會功能恢復",[11,24,25],{},"基本的受損類型為",[27,28,29,33,36],"ul",{},[30,31,32],"li",{},"拉傷：如BPI的Erb palsy（小費手），或肱骨骨折引起的橈神經損傷",[30,34,35],{},"撕裂型損傷：如切傷",[30,37,38,39],{},"壓迫性損傷：缺血，或機械性壓迫",[27,40,41],{},[30,42,43],{},"例如給別人枕著自己的手睡覺",[11,45,46],{},"以神經損傷類型，從輕到重分別為",[27,48,49,63,77],{},[30,50,51,52],{},"神經失用症（一級損傷）",[27,53,54,57,60],{},[30,55,56],{},"會出現暫時性傳導阻斷，並伴有脫髓鞘",[30,58,59],{},"對叩擊測試無反應",[30,61,62],{},"若讓區域髓鞘再生，可完全恢復，時間若需12周",[30,64,65,66],{},"軸突退化（二級損傷）",[27,67,68,71,74],{},[30,69,70],{},"受傷的神經遠端會出現瓦勒氏退化，且會往近端漫延至少一個郎氏結（node of Ranvier）",[30,72,73],{},"有去神經化病變",[30,75,76],{},"軸突再生會按照每月1 inch\u002F每天1 mm的速度再生（當神經重新支配後可完全恢復）",[30,78,79,80],{},"神經斷傷（三，四，五級損傷）",[27,81,82,98,115],{},[30,83,84,85],{},"三級：與二級類似，但較嚴重（傷及內膜）",[27,86,87],{},[30,88,89,90],{},"內膜並非完好無缺，有可能導致軸突長回原本支配的地方",[27,91,92,95],{},[30,93,94],{},"會有神經誤接問題",[30,96,97],{},"去神經過久，且距離受傷部位過遠，可能導致再支配不完全",[30,99,100,101],{},"四級：傷及束膜（亂長）",[27,102,103,106,109,112],{},[30,104,105],{},"受傷部位會出現大量疤痕組織，並阻礙軸突向受傷部重再生",[30,107,108],{},"有去神經病變",[30,110,111],{},"受傷的level可用叩擊測試觀察到，但不會超高受傷level",[30,113,114],{},"只能做手術接回去，軸突才會繼續再生並再支配",[30,116,117,118],{},"五級：完全斷裂",[27,119,120],{},[30,121,122],{},"需做手術接回去才能恢復",[124,125],"hr",{},[11,127,128],{},"診斷可利用",[27,130,131,142],{},[30,132,133,134],{},"EMG",[27,135,136,139],{},[30,137,138],{},"可在神經損傷發生4周後測試",[30,140,141],{},"若為顫動電位，代表去神經化；若有運動單位電位，代表再支配",[30,143,144,145],{},"神經傳導檢查",[27,146,147],{},[30,148,149],{},"可確認病變部位及程度",[11,151,152],{},"PNI的症狀包括",[27,154,155,158,161],{},[30,156,157],{},"運動症狀：肌肉麻痺，動作模式改變（代償），攣縮",[30,159,160],{},"感覺症狀：感覺喪失，疼痛",[30,162,163,164],{},"交感神經症狀：",[27,165,166,169,172,175,178],{},[30,167,168],{},"皮膚乾燥，變薄，失去彈性",[30,170,171],{},"指甲出現修紋，變脆",[30,173,174],{},"毛髮變長，變濃密，顏色變深",[30,176,177],{},"血流量減少，顏色變深",[30,179,180],{},"皮下組織萎縮",[11,182,183,184,187],{},"PNI的初期治療，首先保護關節，包括周圍韌帶和肌腱，以免進一步受壓",[185,186],"br",{},"\n可利用副木（橈神經損傷），懸吊帶（BPI），或兩者兼用",[11,189,190],{},"早期階段，在受影響關節進行PROM，對未受影響的關節進行AROM\u002FARROM",[11,192,193,194,196,197,199],{},"以電刺激可來預防肌肉退化（臨床上會用，雖研究上沒有實證）",[185,195],{},"\n若為去神經肌肉，用直流電；若為再支配肌肉，用交流電",[185,198],{},"\n亦可利用運動與生物回饋增加再支配肌肉的肌力",[11,201,202],{},"以下為手術的適應症",[27,204,205,208,211],{},[30,206,207],{},"閉合性損傷：在受傷後三個月，用EMG或電學檢查，沒有恢復的跡象",[30,209,210],{},"開放性損傷：凡是感覺喪失或運動無力的個案，應手術處置",[30,212,213],{},"擠壓傷：若在三個月後，經檢查無恢復跡象，應手術處置",[11,215,216],{},"手術的處置分別為神經修復，神經移植，神經轉移",[11,218,219],{},"術前評估包括感覺評估（兩點辦識覺和輕觸覺）和運動評估（握力和MMT）",[11,221,222,223,225,226,228],{},"在術後，需先用厚敷料固定好，神經修復需固定3周；神經移植需固定10~14天",[185,224],{},"\n可對固定區域附近的近遠端關節做ROM",[185,227],{},"\n配戴好副木固定，隨後進行運動",[27,230,231,234],{},[30,232,233],{},"維持未受影響運動的肌力",[30,235,236],{},"可進行感覺與運動再教育，將治療最大化",[11,238,239],{},"那軸突也有三種生理機制",[27,241,242,245,248],{},[30,243,244],{},"一種是快軸突運輸，用來運送離子通道跟神經傳導物質（100~400mm\u002Fday）",[30,246,247],{},"一種是慢軸突運輸，用來維持神經細胞健康（6mm\u002Fday）",[30,249,250],{},"一種是逆軸突運輸，用來影響細胞核活動（200mm\u002Fday）",[124,252],{},[11,254,255],{},"PNI類型分別有",[27,257,258,269,289],{},[30,259,260,261],{},"創傷",[27,262,263,266],{},[30,264,265],{},"開放性損傷：刀割，骨折，槍傷，燒傷等",[30,267,268],{},"閉合性損傷：腔室症候群，骨折\u002F脫位，電燒傷，輻射，注射",[30,270,271,272],{},"壓迫",[27,273,274,277,280,283,286],{},[30,275,276],{},"橈神經",[30,278,279],{},"尺神經",[30,281,282],{},"正中神經",[30,284,285],{},"坐骨神經",[30,287,288],{},"總腓神經",[30,290,291,292],{},"病變",[27,293,294,297,300,303,306,309],{},[30,295,296],{},"遺傳",[30,298,299],{},"原發性",[30,301,302],{},"疾病",[30,304,305],{},"內分泌",[30,307,308],{},"環境毒物",[30,310,311],{},"營養不良",[11,313,314],{},"BPI（嗯對又是BPI）",[27,316,317,320],{},[30,318,319],{},"Erb-Duchenne paralysis：是C5~C6受損，呈現下垂姿勢，在肩內收，肩內旋，前臂旋前，手指屈曲的姿勢；（5%機率伴有呼吸困難）",[30,321,322],{},"Klumpke paralysis：是C8~T1受損，三頭肌，前臂旋前肌，腕曲肌，手部內在肌無力；有霍納氏症候群",[11,324,325],{},"Bell's 麻痺：15%的人長期患有顏面功能障礙，恢復期需2周~1年不等；治療包括電刺激，按摩，熱敷，視覺回饋",[124,327],{},[11,329,330],{},"照護",[27,332,333,356],{},[30,334,335,336],{},"失用症與軸突損傷：",[27,337,338,341,344,347,350,353],{},[30,339,340],{},"癒合期用最少程度的固定",[30,342,343],{},"減少水腫",[30,345,346],{},"衛教",[30,348,349],{},"AROM\u002FPROM",[30,351,352],{},"皮膚照護",[30,354,355],{},"手部的功能性使用",[30,357,358,359],{},"神經斷裂",[27,360,361,369,380],{},[30,362,363,364],{},"急性期",[27,365,366],{},[30,367,368],{},"固定，減少水腫，維持ROM，衛教，監測疼痛",[30,370,371,372],{},"早期復健階段",[27,373,374,377],{},[30,375,376],{},"四周後移除副木，減少水腫，改善ROM，衛教",[30,378,379],{},"禁忌症：抬高患肢，阻力運動，拉伸，用力抓握，提重物",[30,381,382,383],{},"後期復健階段",[27,384,385,388,391],{},[30,386,387],{},"改善肌力、動作協調、功能性活動，預防攣縮",[30,389,390],{},"訓練項目：阻力運動，握力，提重物，ADL",[30,392,393],{},"皮膚照護，工作評估，副木配戴評估，後續追蹤",[11,395,396],{},"整體評估內容",[27,398,399,402,405,408,411,414,417,420],{},[30,400,401],{},"損傷程度",[30,403,404],{},"水腫",[30,406,407],{},"疼痛",[30,409,410],{},"ROM",[30,412,413],{},"皮膚狀況",[30,415,416],{},"感覺喪失，",[30,418,419],{},"肌肉癱瘓",[30,421,422],{},"畸型",{"title":424,"searchDepth":425,"depth":425,"links":426},"",2,[],"2026-06-19","周邊神經損傷",false,"md","\u002Fimages\u002Fuploads\u002F1781874613115-146192617_p0_master1200.webp",{},true,"\u002Fblog\u002FPNI",{"title":5,"description":428},{"loc":434},"blog\u002FPNI",null,"NmKnQnRtZ1WKktcxf-vqCAgLPlhxuTyV9JEoaGbkbpQ",153,{"id":442,"extension":443,"meta":444,"series":445,"stem":604,"__hash__":605},"series\u002Fseries.json","json",{},{"微積分教學":446,"生活紀錄":449,"Motor 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PPS",[124,870],{},[872,873,603],"h2",{"id":874},"pps",[11,876,877],{},"PPS大概在小兒麻痺症急性期的35年後發生（延遲性的）",[11,879,880,881,883,884,888,890],{},"主要問題為ROM過大，肌肉輕癱和癱瘓",[185,882],{},"\n次要問題為疲勞，深層的肌肉疼痛，",[817,885,887],{"className":886},[820,821],"原本無事的肌肉也會無力",[185,889],{},"\n其他的問題包括肌肉痙攣，肌束顫動，怕冷，吞嚥困難，通氣不足，睡眠障礙",[892,893,894,917],"table",{},[895,896,897],"thead",{},[898,899,900,907,912],"tr",{},[901,902,904],"th",{"align":903},"left",[784,905,906],{},"健康與生活問題 (Health problems \u002F ADL problems)",[901,908,909],{"align":903},[784,910,911],{},"人數 (No.)",[901,913,914],{"align":903},[784,915,916],{},"百分比 (%)",[918,919,920,936,949,962,973,989,1002,1015,1028,1041,1055,1070,1083,1096],"tbody",{},[898,921,922,928,932],{},[923,924,925],"td",{"align":903},[784,926,927],{},"健康問題 (Health problems)",[923,929,930],{"align":903},[185,931],{},[923,933,934],{"align":903},[185,935],{},[898,937,938,941,944],{},[923,939,940],{"align":903},"* 疲勞 (Fatigue)",[923,942,943],{"align":903},"117",[923,945,946],{"align":903},[784,947,948],{},"89%",[898,950,951,954,957],{},[923,952,953],{"align":903},"* 肌肉疼痛 (Muscle pain)",[923,955,956],{"align":903},"93",[923,958,959],{"align":903},[784,960,961],{},"71%",[898,963,964,967,969],{},[923,965,966],{"align":903},"* 關節疼痛 (Joint pain)",[923,968,956],{"align":903},[923,970,971],{"align":903},[784,972,961],{},[898,974,975,981,985],{},[923,976,977,978],{"align":903},"* ",[784,979,980],{},"無力 (Weakness)",[923,982,983],{"align":903},[185,984],{},[923,986,987],{"align":903},[185,988],{},[898,990,991,994,997],{},[923,992,993],{"align":903},"     - 先前已受影響的肌肉 (Previously affected muscles)",[923,995,996],{"align":903},"91",[923,998,999],{"align":903},[784,1000,1001],{},"69%",[898,1003,1004,1007,1010],{},[923,1005,1006],{"align":903},"     - 先前未受影響的肌肉 (Previously unaffected muscles)",[923,1008,1009],{"align":903},"66",[923,1011,1012],{"align":903},[784,1013,1014],{},"50%",[898,1016,1017,1020,1023],{},[923,1018,1019],{"align":903},"* 耐寒性差 \u002F 怕冷 (Cold intolerance)",[923,1021,1022],{"align":903},"38",[923,1024,1025],{"align":903},[784,1026,1027],{},"29%",[898,1029,1030,1033,1036],{},[923,1031,1032],{"align":903},"* 肌肉萎縮 (Atrophy)",[923,1034,1035],{"align":903},"37",[923,1037,1038],{"align":903},[784,1039,1040],{},"28%",[898,1042,1043,1047,1051],{},[923,1044,1045],{"align":903},[185,1046],{},[923,1048,1049],{"align":903},[185,1050],{},[923,1052,1053],{"align":903},[185,1054],{},[898,1056,1057,1062,1066],{},[923,1058,1059],{"align":903},[784,1060,1061],{},"日常生活活動問題 (ADL problems)",[923,1063,1064],{"align":903},[185,1065],{},[923,1067,1068],{"align":903},[185,1069],{},[898,1071,1072,1075,1078],{},[923,1073,1074],{"align":903},"* 走路 (Walking)",[923,1076,1077],{"align":903},"84",[923,1079,1080],{"align":903},[784,1081,1082],{},"64%",[898,1084,1085,1088,1091],{},[923,1086,1087],{"align":903},"* 爬樓梯 (Climbing stairs)",[923,1089,1090],{"align":903},"80",[923,1092,1093],{"align":903},[784,1094,1095],{},"61%",[898,1097,1098,1101,1104],{},[923,1099,1100],{"align":903},"* 穿衣服 (Dressing)",[923,1102,1103],{"align":903},"23",[923,1105,1106],{"align":903},[784,1107,1108],{},"17%",[11,1110,1111],{},"原因未明，但目前推論下來可能的機制有",[27,1113,1114,1117,1128],{},[30,1115,1116],{},"老化伴隨神經元流失（60歲）：那些病毒原本就有侵害過神經元，所以出現早衰現象",[30,1118,1119,1120],{},"巨大運動單元的代謝要求增加，並伴隨軸突發芽的修剪",[27,1121,1122,1125],{},[30,1123,1124],{},"Pruning（修剪）＞sprouting cause（發芽）：繼而導致肌無力和疲勞？",[30,1126,1127],{},"這些修剪太快的神經所支配的肌纖維出現去神經現象",[30,1129,1130],{},"巨大運動單元在神經節點處的神經衝動傳導不穩定或衰竭（已在EMG證實）",[124,1132],{},[11,1134,1135],{},"PPS的診斷",[27,1137,1138,1141,1144,1147],{},[30,1139,1140],{},"有小兒麻痺症病史",[30,1142,1143],{},"肌力和功能達到部份或完全恢復",[30,1145,1146],{},"有過一段穩定期",[30,1148,1149],{},"期間沒有其他疾病可以造成這些問題",[11,1151,1152],{},"檢查跟評估",[27,1154,1155,1158,1161,1164,1167,1170,1173],{},[30,1156,1157],{},"病史：包含手術史",[30,1159,1160],{},"MMT",[30,1162,1163],{},"ROM：看是否有活動度過大，過小，或是攣縮",[30,1165,1166],{},"分析身體活動能力：根據活動強度，時長，類型分析；以及進行ADL測試",[30,1168,1169],{},"觀察其習慣：睡姿，坐姿，站姿，步行姿勢",[30,1171,1172],{},"根據其問題，進行調整後的脊椎及上下肢篩檢評估",[30,1174,1175],{},"評估是否需要輔具介入",[11,1177,1178],{},"介入",[27,1180,1181,1192,1195],{},[30,1182,1183,1184],{},"長期目標",[27,1185,1186,1189],{},[30,1187,1188],{},"提供患者自我管理的原則跟方法",[30,1190,1191],{},"改變生活方式，減少肌肉過度的代謝負荷",[30,1193,1194],{},"衛教患者與家屬",[30,1196,1197,1198],{},"針對以下問題處置",[27,1199,1200,1261,1283,1314,1330,1341,1357],{},[30,1201,407,1202],{},[27,1203,1204,1218,1258],{},[30,1205,1206,1207],{},"肌肉痛：會同時出現在正常或無力的肌肉，且藥物或物理因子治療對緩解無效",[27,1208,1209,1212,1215],{},[30,1210,1211],{},"活動會增劇，休息會減輕",[30,1213,1214],{},"建議的方法有：做不會累的功能性活動；教導節能技巧；改變生活方弌",[30,1216,1217],{},"會需要數月才會恢復",[30,1219,1220,1221],{},"關節痛：",[27,1222,1223,1234,1242,1250],{},[30,1224,1225,1226],{},"並非PPS直接導致的問題",[27,1227,1228,1231],{},[30,1229,1230],{},"可能包括OA，薦髂關節炎，大轉子滑囊炎，膝關節與踝關節的韌帶鬆弛，髕股關節軌跡問題，肩膀夾擠，外上髁炎，腕隧道症候群",[30,1232,1233],{},"異常步態和姿勢異常",[30,1235,1236,1237],{},"治療方法為",[27,1238,1239],{},[30,1240,1241],{},"休息，機械性矯正，冰敷（1天6~10次），NSAID，輔具，ROM，McConnell taping technique（可緩解髕股疼痛）",[30,1243,1244,1245],{},"居家計劃",[27,1246,1247],{},[30,1248,1249],{},"抑制痙攣，伸展肌肉和筋膜，減少水腫，增加關節結構的營養",[30,1251,1252,1253],{},"放鬆方法",[27,1254,1255],{},[30,1256,1257],{},"冥想，改良的太極，水中運動，身體覺查技術（Feldenkrais method）",[30,1259,1260],{},"其他類型的疼痛：來自軀幹手術的疼痛，減敏運動，TENS",[30,1262,1263,1264],{},"異常疲勞",[27,1265,1266,1269],{},[30,1267,1268],{},"程度嚴重，且與活動類型無關，基本每天固定在中午會發生，導致他們減少活動，使得社交圈變小",[30,1270,1271,1272],{},"治療方法：",[27,1273,1274,1277,1280],{},[30,1275,1276],{},"教導不易引起疲勞的活動，和節能技巧",[30,1278,1279],{},"將活動分段拆開，安排密集的休息時間",[30,1281,1282],{},"如有必要，請病假4~6周或辦理退休",[30,1284,1285,1286],{},"新肌肉無力：基本顯現在重複性與維持穩定的肌肉，而非單次最大收縮的肌肉",[27,1287,1288,1291,1308,1311],{},[30,1289,1290],{},"不易使用MMT檢測",[30,1292,1293,1294],{},"徵象",[27,1295,1296,1299,1302,1305],{},[30,1297,1298],{},"使用EMG可測出肌束顫動",[30,1300,1301],{},"肌肉痙攣",[30,1303,1304],{},"肌肉萎縮",[30,1306,1307],{},"血液中的CK值上升",[30,1309,1310],{},"可能原因是overuse",[30,1312,1313],{},"治療方式與疲勞相似",[30,1315,1316,1317],{},"怕冷",[27,1318,1319,1322],{},[30,1320,1321],{},"因為交感神經被侵害，使動靜脈收縮能力下降，導致熱量散失",[30,1323,1324,1325],{},"患者會抗拒在受傷部位冰敷",[27,1326,1327],{},[30,1328,1329],{},"需衛教",[30,1331,1332,1333],{},"睡眠障礙",[27,1334,1335,1338],{},[30,1336,1337],{},"原因可能為：疼痛，壓力，換氣不足，阻塞性睡眠中止症",[30,1339,1340],{},"PT可以緩解疼痛，且可利用氣墊床，護頸枕等進行睡眠姿勢調整",[30,1342,1343,1344],{},"危及生命情況",[27,1345,1346,1349],{},[30,1347,1348],{},"通氣不足，吞嚥困難，心肺功能不全，當年的小兒麻痺導致的延髓病變並伴有嚴重駝背或側彎",[30,1350,1351,1352],{},"PT能做的",[27,1353,1354],{},[30,1355,1356],{},"調整活動，導致舌咽呼吸法GPB，徒手協助排痰，支氣管引流",[30,1358,1359,1360],{},"減輕肌肉的負荷",[27,1361,1362,1382,1385,1399,1427,1435],{},[30,1363,1364,1365],{},"節能技巧",[27,1366,1367,1370,1373,1376,1379],{},[30,1368,1369],{},"同一趟做多件事",[30,1371,1372],{},"用不費力的技巧做",[30,1374,1375],{},"利用科技",[30,1377,1378],{},"一件事拆開做，分段休息",[30,1380,1381],{},"可請人代勞",[30,1383,1384],{},"減重",[30,1386,1387,1388],{},"移動方式",[27,1389,1390,1393,1396],{},[30,1391,1392],{},"疼痛，疲勞，無力的原因為能因長年柱拐杖或手推輪椅",[30,1394,1395],{},"手腕和手部有較高機率患OA",[30,1397,1398],{},"可改用電動輪椅",[30,1400,1401,1402],{},"姿勢矯正",[27,1403,1404,1421,1424],{},[30,1405,1406,1407],{},"可能因為軀幹肌肉輕瘓，骨盤基底不對策，腰椎與頸椎生理曲線喪失",[27,1408,1409,1412,1415,1418],{},[30,1410,1411],{},"在坐姿下，利用機械性方式重建腰椎生理曲線",[30,1413,1414],{},"針對腹肌癱瘓，可使用馬甲（corsets）",[30,1416,1417],{},"頸部無力，可使用頸圈",[30,1419,1420],{},"嚴重的軀幹肌肉癱瘓或側彎，可使用馬甲，背架，或貼身塑型裝具(Molded body jackets)",[30,1422,1423],{},"拉伸（需評估是否必要）",[30,1425,1426],{},"溫和的肌筋膜放鬆，可減少疼痛與痙攣，增加被拉伸區域的營養供給，延長肌肉",[30,1428,1429,1430],{},"矯具：PPS患者對於矯具的印象是負面的",[27,1431,1432],{},[30,1433,1434],{},"可穿戴HKAFO",[30,1436,1437,1438],{},"運動：需非常保守，因為PPS病人又無力又會疼痛還會累",[27,1439,1440,1448],{},[30,1441,1442,1443],{},"強度是最大的一半，次數減半，休息加倍",[27,1444,1445],{},[30,1446,1447],{},"假如這個標準下疲勞不超高30分鐘，兩天內消失，不會疼，就用這個標準繼續",[30,1449,1450],{},"要知道是過勞問題還是廢用",{"title":424,"searchDepth":425,"depth":425,"links":1452},[1453],{"id":874,"depth":425,"text":603},"2026-06-02","小兒麻痺後症候群","\u002Fimages\u002Fuploads\u002F1781850952157-146057302-991362560592f4752f3b0dc4f831919a_p0_master1200.webp",{},"\u002Fblog\u002FPPS",{"title":603,"description":1455},{"loc":1458},"blog\u002FPPS","E74r6tCUoUIpSgLGEq2kfIygfKNEPo6D8NWB-KblAbg",{"id":4,"title":5,"author":6,"body":1464,"date":427,"description":428,"draft":429,"edited_at":427,"extension":430,"featured_image":431,"meta":1762,"navigation":433,"path":434,"pinned":429,"seo":1763,"sitemap":1764,"stem":437,"tags":438,"__hash__":439},{"type":8,"value":1465,"toc":1760},[1466,1468,1470,1472,1474,1476,1488,1490,1546,1548,1550,1566,1568,1588,1592,1594,1600,1602,1610,1612,1614,1620,1626,1628,1636,1638,1640,1680,1682,1688,1690,1692,1694,1740,1742],[11,1467,13],{},[11,1469,16],{},[11,1471,19],{},[11,1473,22],{},[11,1475,25],{},[27,1477,1478,1480,1482],{},[30,1479,32],{},[30,1481,35],{},[30,1483,38,1484],{},[27,1485,1486],{},[30,1487,43],{},[11,1489,46],{},[27,1491,1492,1502,1512],{},[30,1493,51,1494],{},[27,1495,1496,1498,1500],{},[30,1497,56],{},[30,1499,59],{},[30,1501,62],{},[30,1503,65,1504],{},[27,1505,1506,1508,1510],{},[30,1507,70],{},[30,1509,73],{},[30,1511,76],{},[30,1513,79,1514],{},[27,1515,1516,1528,1540],{},[30,1517,84,1518],{},[27,1519,1520],{},[30,1521,89,1522],{},[27,1523,1524,1526],{},[30,1525,94],{},[30,1527,97],{},[30,1529,100,1530],{},[27,1531,1532,1534,1536,1538],{},[30,1533,105],{},[30,1535,108],{},[30,1537,111],{},[30,1539,114],{},[30,1541,117,1542],{},[27,1543,1544],{},[30,1545,122],{},[124,1547],{},[11,1549,128],{},[27,1551,1552,1560],{},[30,1553,133,1554],{},[27,1555,1556,1558],{},[30,1557,138],{},[30,1559,141],{},[30,1561,144,1562],{},[27,1563,1564],{},[30,1565,149],{},[11,1567,152],{},[27,1569,1570,1572,1574],{},[30,1571,157],{},[30,1573,160],{},[30,1575,163,1576],{},[27,1577,1578,1580,1582,1584,1586],{},[30,1579,168],{},[30,1581,171],{},[30,1583,174],{},[30,1585,177],{},[30,1587,180],{},[11,1589,183,1590,187],{},[185,1591],{},[11,1593,190],{},[11,1595,193,1596,196,1598,199],{},[185,1597],{},[185,1599],{},[11,1601,202],{},[27,1603,1604,1606,1608],{},[30,1605,207],{},[30,1607,210],{},[30,1609,213],{},[11,1611,216],{},[11,1613,219],{},[11,1615,222,1616,225,1618,228],{},[185,1617],{},[185,1619],{},[27,1621,1622,1624],{},[30,1623,233],{},[30,1625,236],{},[11,1627,239],{},[27,1629,1630,1632,1634],{},[30,1631,244],{},[30,1633,247],{},[30,1635,250],{},[124,1637],{},[11,1639,255],{},[27,1641,1642,1650,1664],{},[30,1643,260,1644],{},[27,1645,1646,1648],{},[30,1647,265],{},[30,1649,268],{},[30,1651,271,1652],{},[27,1653,1654,1656,1658,1660,1662],{},[30,1655,276],{},[30,1657,279],{},[30,1659,282],{},[30,1661,285],{},[30,1663,288],{},[30,1665,291,1666],{},[27,1667,1668,1670,1672,1674,1676,1678],{},[30,1669,296],{},[30,1671,299],{},[30,1673,302],{},[30,1675,305],{},[30,1677,308],{},[30,1679,311],{},[11,1681,314],{},[27,1683,1684,1686],{},[30,1685,319],{},[30,1687,322],{},[11,1689,325],{},[124,1691],{},[11,1693,330],{},[27,1695,1696,1712],{},[30,1697,335,1698],{},[27,1699,1700,1702,1704,1706,1708,1710],{},[30,1701,340],{},[30,1703,343],{},[30,1705,346],{},[30,1707,349],{},[30,1709,352],{},[30,1711,355],{},[30,1713,358,1714],{},[27,1715,1716,1722,1730],{},[30,1717,363,1718],{},[27,1719,1720],{},[30,1721,368],{},[30,1723,371,1724],{},[27,1725,1726,1728],{},[30,1727,376],{},[30,1729,379],{},[30,1731,382,1732],{},[27,1733,1734,1736,1738],{},[30,1735,387],{},[30,1737,390],{},[30,1739,393],{},[11,1741,396],{},[27,1743,1744,1746,1748,1750,1752,1754,1756,1758],{},[30,1745,401],{},[30,1747,404],{},[30,1749,407],{},[30,1751,410],{},[30,1753,413],{},[30,1755,416],{},[30,1757,419],{},[30,1759,422],{},{"title":424,"searchDepth":425,"depth":425,"links":1761},[],{},{"title":5,"description":428},{"loc":434},1781875089345]