At present, the number of stroke patients in China is as high as 13 million, which is more than 11 million of coronary heart disease, and it is the number one killer that jeopardizes our life and health. In particular, the sequelae of cerebral infarction is plagued by patients and even the entire family, a cerebral infarction sequelae patients, the family will have to be taken care of, both from the psychological and physical to the patient brought great pain.
What is the best treatment for cerebral infarction? The first is to minimize the after-effects? Can the thrombus be removed?
At present, the most effective way to treat acute cerebral infarction is to remove the thrombus or thrombolysis, let's start with what the guideline says:
1. The Chinese guideline recommends at the highest level: for patients with cerebral infarction of anterior circulation occlusion within 6 hours of the onset of cerebral infarction, to carry out emergency mechanical thrombus extraction treatment.
2. The U.S. guidelines state that patients with acute cerebral infarction caused by occlusion of the anterior large arteries within 6 hours of onset of the disease can undergo emergency mechanical thrombolysis.
3, European organization guidelines recommend: for the onset of 6 hours and with anterior circulation of large artery occlusion of patients, within 4.5 hours of the onset of intravenous thrombolysis based on a combination of emergency mechanical thrombolysis treatment.
So, if the diagnosis is made early, the thrombus can be removed, but not all cerebral infarcts are suitable for thrombus removal, and not all hospitals can remove the thrombus, and only a very few hospitals have this level of medical care.
Acute phase, if within the time window, there are indications for thrombolysis, thrombolysis can be carried out, commonly used drugs for urokinase and recombinant tissue-type activator of fibrinolytic enzymes, the current commonly used thrombolytic drugs rtPA, also known as the thrombolytic drug of alteplase, the drug can open up occluded blood vessels, restore cerebral blood flow, is the world recognized as the most effective treatment for the treatment of acute cerebral infarction treatment, the premise is that it must be in the The drug is administered within 4.5 hours of onset. The most significant risk of rtPA treatment is the possibility of cerebral hemorrhage, which occurs with a probability of about 6%, with resulting deaths in only 1%, and significant symptomatic improvement in 33% of patients. Overall, therefore, the potential benefits of this treatment far outweigh the risks. If the patient is able to arrive at the hospital within three hours, the probability of having a brain hemorrhage is lower and the outcome is better with this treatment.
Therefore, it is important to arrive at the hospital as soon as an acute cerebral infarction occurs to avoid any time delays. Within three to six hours after the occurrence of acute cerebral infarction is the "golden time" for treatment. Thrombolysis can open the occluded blood vessels as soon as possible, restore or improve the perfusion of ischemic brain tissue, which is a milestone in the treatment of cerebral infarction, and will greatly reduce the disability and mortality rate of patients.
So, no matter whether it's thrombolysis or thrombolysis, for patients, one word "early", only early to the hospital, there is a chance to get thrombolysis or thrombolysis, in order to reduce the disability, reduce the death.
There are also basic treatments, which every patient needs, or treatments that are past the time window for optimal opening of blood vessels, and basic treatments include antiplatelet aggregation, aspirin or clopidogrel. Anticoagulant therapy, mainly heparin, low molecular heparin. Plaque stabilization and lipid-lowering therapy, statins. Cerebroprotective therapy, including free radical scavengers and calcium channel blockers, can reduce cerebral ischemic injury by decreasing cerebral metabolism and intervening in ischemia-induced cytotoxicity mechanisms. Especially aspirin + statin therapy, basically to accompany the patient's life.
After the acute phase, the subsequent treatment in addition to regular medication, the main thing is rehabilitation, functional exercise, especially those who have obvious sequelae, after the later rehabilitation exercise, many people can reduce sequelae. At the same time, we also need to pay attention to healthy life, quit smoking and drinking, adhere to the appropriate exercise, low-salt, low-fat and low-sugar diet.
Once a cerebral infarction occurs, there is no way to avoid the after-effects and death, even if the diagnosis is made early. Because you can't control the extent and location of the infarction, the best and most effective treatment is prevention, and only effective prevention to minimize the risk of cerebral infarction is really effective treatment.
Cerebral infarction is simply divided into atherosclerosis-induced plaque thrombosis, which accounts for the vast majority of cases, and a portion of cerebral infarction caused by thrombosis due to atrial fibrillation of the heart.
For atrial fibrillation to actively prevent blood clots, long-term use of anticoagulant drugs, such as warfarin, rivaroxaban, dabigatran and so on, so as to effectively prevent cerebral infarction.
For patients with atherosclerosis, those with three highs must actively control the three highs, all should quit smoking, quit drinking, and insist on exercise and healthy diet. For those who have clear carotid plaque, especially soft plaque or stenosis > 50%, they need to take long-term statin drugs to stabilize the plaque.
In short, no matter whether there is no risk of cerebral infarction, should develop good living habits, so high incidence of cerebral infarction disease, what makes us sure that it will not be smashed into their heads? The only thing we can rely on is a healthy life, not luck!
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