(1) Assist in nursing care?
Patients with cerebral thrombosis are mostly obese, and some are also complicated with diabetes. Now they have hemiplegia, local neurotrophic disorders, and prolonged compression can cause skin problems. It breaks down and forms "bedsores". Once it occurs, cerebrovascular disease may be aggravated by infection and fever, and in severe cases, it may cause sepsis and cause death of the patient. Therefore, when accompanying the patient, family members should pay attention to turning him over regularly, patting the back, scrubbing the skin with warm water, and gently massaging the pressed parts, especially the parts with prominent bones, such as the spine, sacrococcyx, etc. The frequency of turning over is generally about 2 hours. If skin ulcers are found, report them to medical staff for early treatment. Patients with incontinence should change their diapers frequently, wash them with warm water, dry them and apply talcum powder after each defecation. ?
(2) Eating problems?
Some patients have difficulty swallowing after illness, which is caused by paralysis of the muscles responsible for swallowing.
The patient chokes and coughs when eating, especially when drinking water, and even food squirts out of the mouth and nose. At this time, care should be taken not to force the patient to drink water or medicine. For mild patients, they can be allowed to eat sticky foods, such as thick porridge, soft rice, etc. Chop vegetables, minced meat and other non-staple foods and mix them with rice. Avoid foods that are too thin or dry, which can be easily swallowed. If there are no contraindications for oral medications, they can be crushed and mixed with food. Severely ill patients need nasogastric feeding, that is, a rubber tube is inserted into the stomach through the nostrils, and food such as rice soup, milk, vegetable juice, etc. are injected into the stomach with a syringe to ensure adequate nutrition. Oral medications can also be injected through a stomach tube. Note that the food and medicine injected must not have large particles to avoid blocking the gastric tube. Nasogastric feeding is a necessary means to ensure treatment at a certain stage, and is directly related to the success or failure of patient rescue. Some patients and their families are unwilling to accept gastric tubes and force the patients to swallow. This is very dangerous. If food is accidentally inhaled into the respiratory tract, it can cause lung infection and aspiration pneumonia in mild cases; in severe cases, death may occur due to suffocation. ?
(3) Pay attention to the changes in the condition and report any abnormalities to medical staff in a timely manner?
Patients with cerebral thrombosis have a relatively slow onset and mild symptoms at the onset. There will be no impairment of consciousness. But the condition may worsen over hours or days. Although medical staff take aggressive treatment measures, sometimes the progression of the disease cannot be stopped. If the blocked blood vessels are large, the area of ??brain tissue necrosis is large, and cerebral edema is obvious, the patient may gradually become drowsy, even if he wakes up, he will fall asleep immediately. Severe cases may enter coma. Family members should pay attention to observe whether the patient's paralyzed limbs gradually become less powerful or even completely unable to move. How is your mental state? If a patient is found to be drowsy or listless, notify medical staff immediately. At the same time, critically ill patients should record their daily food intake, urine output, etc. for doctors’ reference. ?
(4) Help the patient to move the paralyzed limbs early and promote recovery?
If the condition is stable on the second day of the onset, you can start to do passive movements of the limbs, that is, help the patient to move the paralyzed limbs Stretching and flexing activities. This will help promote blood circulation in paralyzed limbs, prevent the formation of deep vein thrombosis, promote muscle strength and joint mobility, and prevent limb contracture and deformation. When inactive, the patient's paralyzed limb should be in an anti-spasmodic position, that is, when lying on his back, place the affected upper limb on a pillow so that it is slightly abducted and externally rotated, the elbow joint is slightly flexed, the wrist joint is slightly dorsiflexed, and the hand is held in an appropriate position. sized cylindrical objects, such as toilet paper rolls. Pad your back to move it forward and upward; pad the outer buttocks of your lower limbs to make your hip joints adduct and push your pelvis forward; place a soft pillow under the knee joint to flex the knee joint; the ankle joint should be kept at 90° to prevent foot drop. The patient's feet can be placed on the bed or wall or a homemade splint can be used. When lying on your back, the head height is 30°, but not too high. When in the lateral position, the paralyzed limb should be placed on top as much as possible. A pillow should be placed in front of the chest and in front of the lower limb. The upper limb should be extended and the lower limb should be flexed and placed on the pillow. ?
(5) Pay attention to the patient's emotional changes?
The patient suddenly loses his ability to move and speak, and even loses his ability to take care of himself and work, which is emotionally unbearable. Therefore, mood changes such as depression and anxiety, moodiness, and even personality changes often occur.
Family members should actively cooperate with medical staff, comfort and encourage patients to cooperate with treatment and rehabilitation exercises. Try to avoid making the patient emotional. ?
Home care and treatment during the recovery period of cerebral thrombosis?
Brain cells die due to ischemia and hypoxia when blood vessels are occluded. The later treatment is started, the larger the blocked blood vessels will be. , the more brain cells die, and brain cells cannot regenerate after death. Therefore, despite many proactive measures taken by doctors, patients will inevitably be left with varying degrees of disability, also known as "sequelae". These sequelae cannot be solved in hospitals, especially general hospitals whose main purpose is to save lives. They need to be treated in rehabilitation hospitals. In our country, the main purpose is to go home for further recuperation and recovery. ?
(1) Take medicine on time and regularly to prevent the recurrence of cerebral thrombosis? After discharge, patients still need to take medicine regularly according to the doctor's instructions to control arteriosclerosis such as diabetes and hypertension. For basic lesions, go to the hospital for regular review. Commonly used drugs include anti-platelet aggregation drugs, such as low-dose aspirin and Diclolide; brain protective drugs, such as nimodipine; oxygen free radical scavengers, such as vitamin E, vitamin C, etc. Some patients hate taking medicine and want to try any advertised medicine, or they think that the more medicine they take, the better. In fact, doing so is bad for your body. Not to mention that the efficacy of drugs may not be as miraculous as advertised, but any drug must be metabolized by the liver and kidneys. Taking too many drugs will increase the burden on the already unhealthy liver and kidneys of the elderly; from a pharmacological point of view, , too many drugs entering the body will interact with each other, reduce their respective efficacy, and even aggravate side effects, causing harm to the body. What medicine to take and how to take it? It's best to follow your doctor's advice and not blindly follow advertisements. ?
(2) Start rehabilitation treatment as early as possible and actively?
As mentioned before, cerebral thrombosis will leave many sequelae, such as monoplegia, hemiplegia, aphasia, etc. The effect of drugs on these sequelae is very limited. However, through active and formal rehabilitation treatment, most patients can take care of themselves, and some can return to work. Those who have the conditions are best to go to a regular rehabilitation hospital for systematic rehabilitation. If you are unable to go to a rehabilitation hospital for treatment due to various reasons, you can purchase some relevant books and videos and perform the treatment at home. Rehabilitation should begin as early as possible. The best time for recovery is within 3 to 6 months after the illness. After half a year, due to muscle atrophy and joint contracture, recovery will be more difficult, but it will also be helpful. ?
(3) Daily life training?
After getting sick, many previous living habits have been broken. In addition to training the affected limb as early as possible and formally, attention should also be paid to developing the strength of the healthy limb. potential. Patients with right-sided hemiplegia who are usually right-handed (right-handed) need to train their left hand to do things. The clothes should be loose and soft, and can be sewn into special styles according to special needs. For example, zippers can be installed on the sleeves of the affected limb to measure blood pressure when going to the doctor. When dressing, put on the paralyzed side first, then the healthy side; when taking off clothes, take off the healthy side first, then the affected side. ?
(4) Face reality and adjust emotions?
As the saying goes: "Sickness comes like a mountain falling, and sickness goes like a thread." This statement is more appropriate for cerebrovascular patients. Facing the fait accompli, we should adjust our emotions and actively carry out rehabilitation in order to return to society as soon as possible. Patients with severe mood disorders can seek help from a doctor and use antidepressants, such as Prozac, which have a good effect on depression and anxiety after cerebrovascular disease. ?
Do patients with cerebral thrombosis have to receive infusion once every six months?
Patients with sequelae of cerebral thrombosis are often encountered in outpatient clinics and require infusion. The reason is that I heard that cerebral thrombosis must be infused once every six months to prevent recurrence of the thrombosis. In fact, this is unfounded. Cerebral thrombosis is a disease that is easy to relapse, but its onset is mainly related to arteriosclerosis and blood viscosity. Prevention and treatment of arteriosclerosis is a long-term problem, which cannot be solved by simply injecting intravenous drip in a few days. It requires daily life and drug treatment. Pay attention to many aspects, and long-term and regular oral administration of anti-arteriosclerosis drugs can also achieve the purpose of preventing thrombosis. On the other hand, infusion is not harmless.
In fact, since intravenous drip injects drugs directly into blood vessels, there are many potential dangers, such as infusion reactions and phlebitis; too fast infusion can lead to heart failure. Therefore, intravenous drip is only necessary when the condition is urgent and the drug needs to be delivered into the body as soon as possible, or when the patient is comatose or otherwise unable to take the drug orally. As a general medical principle: drugs that can be taken orally should not be injected intramuscularly; drugs that can be injected intramuscularly should not be intravenously dripped to reduce the chance of adverse reactions. ?
Dietary care for patients with cerebral thrombosis?
Most patients with cerebral thrombosis are obese, have high blood lipids, high blood sugar, and high blood pressure. These abnormalities are risk factors for arteriosclerosis. . In addition to taking corresponding drug treatment, dietary maintenance plays an important role. ?
1. First of all, obese patients should limit the intake of staple food and reduce their weight to normal or close to the standard weight. Generally, the amount of staple food is controlled at about 300 grams per day. If the patient is not full, he can supplement with vegetables and soy products, and try to develop the habit of eating 80% full. ?
2. Eat less or no animal fat and animal offal, such as fat meat, fatty intestines, and tripe, because these foods contain high cholesterol and saturated fatty acids, which can easily aggravate arteriosclerosis. ?
3. Eat more high-quality protein, such as milk, chickens and ducks (preferably wild chickens), fish, eggs (egg yolks should be eaten less), soy products, and eat less pigs, cows, Mutton, preferably lean meat. ?
4. Eat more vitamin-rich foods, such as fresh fruits, tomatoes, hawthorns, etc. that are rich in vitamin C; soy products, dairy, and eggs that are rich in vitamin B6; and foods that are rich in vitamin E. Green leafy vegetables, beans, etc. ?
5. The diet should be mainly light and avoid being too salty. It is best not to eat pickles. Because eating too much salt can easily cause high blood pressure. ?
6. Eat more fiber-rich foods, such as celery, whole grains, etc., to increase gastrointestinal motility and avoid dry stools. Patients with constipation should drink more water, which can promote defecation and prevent urinary system infections due to increased urination. Some patients are afraid of urinating and do not drink water due to limited mobility, which is very disadvantageous