Most patients with cerebral thrombosis are obese, and some of them are complicated with diabetes. Now they have hemiplegia and local neurotrophic disorder. If pressed for too long, it will cause skin ulceration and form "bedsore". Once it happens, it may aggravate cerebrovascular diseases due to infection and fever, and in severe cases, it may also cause sepsis and lead to death. Therefore, family members should pay attention to turn over and pat the back regularly, scrub the skin with warm water, and gently massage the squeezed parts, especially the parts with prominent bones, such as the spine and sacrococcygeal region. The frequency of turning over is generally about 2 hours. If skin ulceration is found, it should be reported to the medical staff in time for early treatment. Patients with urinary incontinence should change diapers frequently, wash with warm water after each defecation, and apply talcum powder after drying. ?
(2) Dietary problems?
Some patients have dysphagia after illness, which is caused by muscle paralysis responsible for swallowing.
Patients will suffocate when eating, especially when drinking water, and even food will be ejected from the nose and mouth. Be careful not to force the patient to drink water or take medicine at this time. For mild patients, you can eat sticky food, such as thick porridge and soft rice. Cook and chop vegetables, minced meat and other non-staple foods and mix them into rice to avoid food that is too thin and dry and easy to swallow. If oral drugs have no contraindications, they can be ground and mixed in food. Severe patients need nasal feeding diet, that is, inserting a hose into the stomach through the nostril and injecting rice soup, milk, vegetable juice and other foods into the stomach with a syringe to ensure adequate nutrition. Oral drugs can also be injected from the stomach tube. Note that the injected food and drugs must not have large particles, so as not to block the stomach tube. Nasal feeding diet is a necessary means to ensure the treatment to a certain stage, which is directly related to the success or failure of patient rescue. Some patients and their families are unwilling to accept a gastric tube, and it is very dangerous for patients to swallow it reluctantly. If inhaled into the respiratory tract by mistake, it will cause lung infection and aspiration pneumonia. In severe cases, people may suffocate to death. ?
(3) Pay attention to the change of illness, and report the abnormal situation to the medical staff in time?
Patients with cerebral thrombosis have relatively slow onset, mild symptoms at onset, and most of them will not have disturbance of consciousness. However, the condition may get worse in a few hours or days. Although the medical staff have taken active measures to treat the disease, sometimes they can't stop the development of the disease. If the blocked blood vessels are large, the area of brain tissue necrosis is large, and the brain edema is obvious, the patient may gradually become sleepy, that is, he can wake up instead of falling asleep immediately. Severe cases can enter a coma. Family members should pay attention to observe whether the paralytic limb strength of the patient gradually decreases or even can't move at all. What's your mental state? If the patient is found to be sleepy and listless, the medical staff should be informed immediately. At the same time, for critically ill patients, it is necessary to record the daily drinking water and urine volume for doctors' reference. ?
(4) early help patients to move their paralyzed limbs and promote rehabilitation?
On the second day after onset, if the condition is stable, you can start to do passive movements of limbs, that is, to help paralyzed patients stretch and flex their limbs. This is conducive to promoting blood circulation of paralyzed limbs, preventing deep vein thrombosis, promoting muscle strength and joint mobility, and preventing limb contracture and deformation. When inactive, the paralyzed limb of the patient should be placed in the spasmolytic position, that is, in the supine position, the affected upper limb should be placed on the pillow, so that it will be slightly abduction and rotation, the elbow joint will be slightly flexed, and the wrist joint will be slightly extended back, and a cylindrical object of appropriate size, such as a toilet paper roll, should be held. Pad your back so that it is forward and upward; The lateral hip pad of the lower limb makes the hip joint adducte and the pelvis lean forward. The soft pillow under the knee joint bends the knee joint, and the ankle joint should be kept at 90 degrees to prevent the foot from sagging, so that patients can put their feet on the bed or wall or make their own splint. When lying on your back, the head height should be 30, not too high. When lying on your side, put the paralyzed limbs as well as possible, put a pillow in front of your chest and lower limbs, straighten your upper limbs and bend your lower limbs on the pillow. ?
(5) Pay attention to the patient's emotional changes?
Patients suddenly lose their activity ability and language ability from normal people, even lose their ability to take care of themselves and work, which is emotionally unbearable, so they often have emotional changes such as depression, anxiety, moodiness and even personality changes. Family members should actively cooperate with medical staff to comfort and encourage patients to cooperate with treatment and rehabilitation exercises. Try to avoid making patients emotional. ?
Family nursing and treatment of cerebral thrombosis in convalescence?
When blood vessels are occluded, brain cells die due to ischemia and hypoxia. The later the treatment is started, the larger the blocked blood vessels are, the more brain cells die, and the brain cells cannot regenerate after death. Therefore, although doctors have taken many positive measures, patients still inevitably have to leave different degrees of disability, which is the so-called "sequelae." These sequelae can't be solved by hospitals, especially general hospitals whose main purpose is to cure diseases and save lives. They need to go home and further recuperate and recover in the rehabilitation hospital. ?
(1) Take medicine regularly to prevent recurrence of cerebral thrombosis? The patient still needs to see a doctor after discharge.
Take medicine regularly, control the basic diseases of arteriosclerosis such as diabetes and hypertension, and go to the hospital for review regularly. Commonly used drugs are anti-platelet aggregation drugs, such as low-dose aspirin and ticlopidine; 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 all the drugs advertised, or think that the more drugs they take, the better. In fact, it's harmful to your health. Not to mention that the efficacy of drugs is not necessarily as magical as advertised. It just means that any drug must undergo liver and kidney metabolism, and taking too much medicine will aggravate the unhealthy burden of liver and kidney for the elderly; Pharmacologically speaking, too many drugs enter the body, which will interact with each other, reduce their respective curative effects, and even aggravate the side effects, causing harm to the body. What medicine to take and how to take it? You'd better follow the doctor's advice and don't blindly follow advertisements. ?
(2) Actively start rehabilitation as soon as possible?
As mentioned above, cerebral thrombosis will leave many sequelae, such as paralysis, hemiplegia and aphasia. And the effect of drugs on these sequelae is very limited. Through active and regular rehabilitation treatment, most patients can take care of themselves and some can return to work. If conditions permit, it is best to go to a regular rehabilitation hospital for systematic rehabilitation. If you can't go to a rehabilitation hospital for various reasons, you can buy some books and videos about it and do them at home. Rehabilitation treatment should be carried out as soon as possible. 3 ~ 6 months after illness is the best recovery time. After half a year, due to muscle atrophy and joint contracture, it is more difficult to recover, but it will also help. ?
(3) daily life training?
Many previous living habits were broken after illness. In addition to training the affected limb as soon as possible and formally, we should also pay attention to developing the potential of healthy limbs. Right hemiplegic patients who are used to using their right hand (right-handed) should train their left hand to do things at this time. Clothes should be made loose and soft, and special styles can be sewn according to special needs. For example, you can install a zipper on the sleeve of the affected limb and measure your blood pressure when you go to see a doctor. Wear the paralyzed side first and then the healthy side when dressing; When undressing, take off the healthy side first and then the affected side. ?
(4) Face the reality and adjust your mood?
As the saying goes: "Illness comes like a mountain, and illness goes like reeling". This is more suitable for people with cerebrovascular diseases. Facing the fait accompli, we should adjust our emotions and actively carry out rehabilitation treatment in order to return to society as soon as possible. Patients with severe emotional disorders can seek help from doctors and use antidepressants, such as Prozac, which has a good effect on depression and anxiety after cerebrovascular disease. ?
Do patients with cerebral thrombosis have to have blood transfusion once every six months?
Outpatients who often encounter sequelae of cerebral thrombosis need infusion. The reason is that I heard that cerebral thrombosis must be infused once every six months to prevent the recurrence of thrombosis. In fact, this is unfounded. Cerebral thrombosis is a disease that is easy to recur, but its pathogenesis is mainly related to arteriosclerosis and blood viscosity. The prevention and treatment of arteriosclerosis is a long-term problem, which cannot be solved by simple intravenous drip for a few days. Attention should be paid from daily life to drug treatment, and long-term 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, because intravenous drip directly injects drugs into blood vessels, there are many potential dangers, such as infusion reaction and phlebitis. Rapid infusion leads to heart failure. Therefore, intravenous drip is only needed when the patient is in an emergency and needs to be sent into the body as soon as possible, or when the patient is unconscious and cannot take the medicine orally. As a general medical principle: drugs that can be taken orally are not suitable for intramuscular injection; Drugs that can be injected intramuscularly are not suitable for intravenous drip to reduce the chance of adverse reactions. ?
Diet conditioning for patients with cerebral thrombosis?
Most patients with cerebral thrombosis have obesity, hyperlipidemia, hyperglycemia and hypertension, which are risk factors for arteriosclerosis. Besides taking corresponding drugs, diet plays an important role in aftercare. ?
1. First of all, obese patients should limit the intake of staple food and reduce their weight to normal or close to standard weight. Generally, the amount of staple food is controlled at about 300 grams per day. If patients do not have enough to eat, they can supplement vegetables and bean products and try to get into the habit of eating 80% full. ?
2. Eat less or don't eat animal fat and internal organs, such as fat meat, fat intestines and fat belly, because these foods contain high cholesterol and saturated fatty acids, which is easy to aggravate arteriosclerosis. ?
3. Eat more high-quality protein, such as milk, chickens and ducks (preferably wild chai chicken), fish, eggs (eat less yolk) and bean products, and eat less pigs, cattle and mutton, and lean meat is better. ?
4. Eat more foods rich in vitamins, such as fresh fruits, tomatoes and hawthorn rich in vitamin C; Bean products, milk and eggs rich in vitamin B6; Green leafy vegetables and beans rich in vitamin e?
5. The diet should be light and salty, and it is best not to eat pickles. Because eating too salty is easy to cause high blood pressure. ?
6. Eat more foods rich in cellulose, such as celery and coarse grains, to increase gastrointestinal peristalsis and avoid dry stools. Constipation patients should drink more water, which can promote defecation, and because of the increase of urine, it is beneficial to prevent urinary system infection. Some patients, because of mobility difficulties, are afraid of urinating instead of drinking water, which is very unfavorable.