[therapy]
Treatment principle: reduce intracranial pressure to control brain edema, prevent the formation of cerebral hernia, reduce elevated blood pressure to prevent rebleeding. Overview ①
The traditional treatment (1) should be kept quiet, and there should not be too many long-distance transportation and scheduling for the absolute bed emergency. Bleeding should never be aggravated. (2) Oral secretion or vomit to keep the respiratory tract unobstructed.
Proper oxygen inhalation and intermittent smoking are suitable for maintaining the balance of nutrition, water and electrolyte;
③。
(b) controlling brain edema and increasing intracranial pressure;
(3) Controlling hypertension and lowering the elevated blood pressure are important measures to prevent rebleeding, but if the blood pressure drops too low, it will not be complete. In general, keep the appropriate ˉˉˉ100 mmhg160/90); 13.3 kpa 20.0 2 1.3/ 12.0( 150
(4) Hemostasis and coagulation drugs will not affect cerebral hemorrhage, such as gastrointestinal bleeding or coagulation dysfunction.
(5) For the prevention and treatment of complications, critically ill patients should pay special attention to basic nursing, regularly and gently change their postures, pay attention to cleaning and drying the skin, prevent bedsores and lung infections, maintain the postural function of limb paralysis, and prevent massage and passive exercise.
Joint contracture surgery,
Traditional Chinese medicine, acupuncture, massage therapy, cooperative therapy, curative effect and rehabilitation. [preventive]
Patients with hypertension should control their blood pressure under the guidance of a doctor to avoid major changes, strenuous activities, defecation and sexual intercourse caused by hypertension. Severe headache, back or neck pain, dyskinesia, dizziness or syncope, nosebleeds and blurred vision may all be precursors of cerebral hemorrhage, so you should go to the hospital for examination.
The dosage and usage of the above drugs must be prescribed by a doctor.
The rupture of most hypertensive cerebrovascular diseases causes sudden increase of blood pressure, sudden cerebral hemorrhage and hypertensive cerebral hemorrhage.
What should I do?
Is cerebral hemorrhage old? It is a common disease in recent years, which is caused by the sudden increase of blood pressure, resulting in cerebral vascular rupture and bleeding. The bleeding blood is directly compressed by edema of peripheral brain tissue, secondary brain displacement and cerebral hernia.
Typical manifestations of cerebral hemorrhage: sudden numbness, weakness or paralysis. At this time, patients often fall to the ground suddenly in an unwitting project, and at the same time, patients will have crooked mouth, drooling, vague language or aphasia, some headaches, vomiting, blurred vision, visual field, disturbance of consciousness, incontinence and other phenomena. Patients with cerebral hemorrhage, their families and emergency rescue.
1。 Stay calm and let the patient lie flat immediately. Patients should not rush to the hospital to avoid the influence of the road, and their heads are tilted to one side, only when sputum and vomit are inhaled into the trachea.
2。 Quickly loosen the collar and belt. Patients should keep good indoor ventilation and keep warm, and pay attention to heatstroke prevention in cold weather and hot weather.
3。 If the patient snores unconsciously and the base of the tongue droops, wrap the patient's tongue with a handkerchief or gauze and gently pull it out.
4。 Cold towel can be used to shrink the patient's head and blood vessels to reduce the amount of bleeding.
5。 Urine incontinence, the patient's body can flow freely on the spot to prevent serious cerebral hemorrhage.
6。 On the way to the hospital, the patient's condition was stable. The vehicle should be driven to reduce bumps as smoothness and vibration. The patient's head should be slightly raised, keeping an angle of 20 degrees with the ground, and always pay attention to the changes of the condition.
Cerebral infarction and cerebral hemorrhage
We should have full confidence and close cooperation in the recovery of the disease. You need to stay in bed first, and you must have an optimistic and cheerful attitude. We will actively treat and recover as soon as possible.
Some patients have one or can't move your hands and feet, and their limbs are weak or temporarily unable to speak, which may have a certain impact on their later lives. They should have a correct understanding of their diseases, early drug control, various functional exercises and language rehabilitation (showing pictures), and persevere, which has played a positive role in the rehabilitation of paralyzed limbs and language function.
Light and digestible, high-protein diet, high vitamins, low fat and rich foods, such as fish, bean products, grains, soybeans and other nutrients, avoid spicy and greasy foods (such as tea, coffee, fried foods), mostly vegetables and fruits, and keep the stool smooth. If facial paralysis, semi-liquid, such as milk paste, will slow down the porridge provided to the healthy side (without facial paralysis), so as to avoid suffocation caused by the patient's cough. In case of critical illness and dysphagia, the doctor will insert a gastric tube and nasal feeding liquid to ensure the supply of nutrition.
The patient's limbs are insensitive and stimulated by cold and heat. Due to the influence of disease, in cold weather, with the help of reminding taboo families, hot water bottles are used to warm up. If you don't do this, it may lead to serious consequences such as burns.
Adverse reactions, incontinence, physical activity to protect the skin, clean the perianal perineal skin, keep dry, and have the corresponding application program, talcum powder, nursing patients every 2 hours, pat the back to avoid long-term compression paralysis of limb skin necrosis, bedsore.
* 1? After two weeks of onset, the early limb function exercise was basically stable, 3 times, each time 10? 20 times, each massage, passive activities to prevent joint adhesion and muscle atrophy. Opinions can help improve sports rehabilitation as soon as possible.
Training methods:
Active exercise, deep breathing and stretching exercises, emphasizing shoulder abduction and leg bending of hemiplegia of hands, feet and upper limbs.
Sports pillow, wooden frame, maintain limb function, prevent upper limb flexion deformity foot drop gap.
* You can gradually increase the practice of sitting, standing and walking, gait, upstairs and downstairs. Pay attention to strengthen protection to prevent accidents such as falling.
At first, the upper limb function recovered, focusing on climbing the wall, picking walnuts and other sports, exercising and taking care of themselves: eating, grooming, dressing and undressing.
Further improve the treatment of writing, knitting, gardening and other labor.
How to communicate aphasia?
1)。 Speak a short and clear sentence, a little slower than usual.
B) Encourage speaking, rather than being forced to ask a simple question, so that patients can answer "yes" or "no"
3) For serious communication problems, you can express your opinions with gestures and facial expressions, and encourage patients to communicate with gestures.
(iv) Talk to patients every day and give them enough time. He thinks that the organization's speech is the content.
5) Be familiar with his name and terminology and talk to him.
What is cerebral hemorrhage? In medical treatment, excluding traumatic cerebral hemorrhage, hypertension is the most common cause. If you suddenly have a severe headache, accompanied by dizziness, nausea, vomiting, confusion, incontinence, elevated blood pressure and adverse events, you may have cerebral hemorrhage.
Patients' health education needs a quiet and comfortable environment, especially after two weeks, they should try to reduce visits to diseases, keep calm and emotional stability, and avoid all kinds of negative emotions.
2。 Absolutely stay in bed for two weeks, gently rotate your head left and right to avoid over-treatment or raising your head, and slightly rotate your limbs in bed every two hours, so don't be too nervous. Urinating in bed, this solution will not be considered in bed to prevent bleeding accidents from happening again.
3。 Some patients are irritable and irritable, and their symptoms are named. We will take restraint protection with a bed guard, which can prevent patients from pulling out the infusion tube or stomach tube by themselves, falling off the bed and causing unnecessary accidents. It may be too harsh on some family members and understand their feelings. Once the patient's condition is stable and he is no longer restless, the ICU, the patient's body, the air cushion bed and the bed stall are all restricted, and we will evacuate immediately to strictly prevent the bed from falling down. I hope we can be satisfied.
4。 Some diseases, such as head swelling pain, needle pricking pain and severe pain, are the most common symptoms. In the process of headache, we will treat it reasonably. With the improvement of the disease, the headache will gradually disappear, so don't be overly nervous and learn to divert your attention. If you still feel terrible pain during the treatment and can't stand it, please tell us that the doctor can take more effective treatment.
5。 Seasonal changes of aging and embrittlement of cardiovascular and cerebrovascular diseases are easy to induce the onset of elderly patients. Long-term bedridden patients complicated with lung infection are not easy to expectorate. We should strengthen drug blocking and slapping back to reduce the loosening of lung infection caused by phlegm and cough. You can't take sputum suction measures when expectoration, I hope.
6。 Staying in bed for more than two hours for a long time is prone to bedsore and pressure sore, and the skin should strengthen its position. Massage pressure to keep skin clean and dry. , the affected limb in place to prevent deformity, etc.
Diet: nutritious, low-fat, light and soft food, such as eggs and bean products. Chew slowly, tilt your head to one side, eat, avoid talking, choking and choking.
8。 Keep the stool unobstructed, eat a banana, honey, drink plenty of water, strengthen the gentle standing posture, massage the abdomen, and reduce constipation patients who can't solve it for a few days or have slow defecation, which can be used to induce defecation. It is forbidden to hold your breath and forcibly defecate to prevent cerebral hemorrhage.
According to the doctor, during the recovery process, shake it by the bed? 15○, according to the degree of tolerance and adaptation, gradually introduce high bedside to semi-recumbent position, 30 minutes a day, from 1-2 hours.
10。 Hypertension is a common cause of this disease. Regular and quantitative drugs will not increase or decrease the use of antihypertensive drugs, but blood pressure will rise and fall sharply, aggravating the condition.
1 1。 After leaving the hospital, follow-up visits were made regularly to monitor blood pressure, cholesterol and other sports activities, such as walking and playing Tai Ji Chuan.
The diet of stroke patients needs medication, and rehabilitation also plays an important role in the rational distribution of food.
Stroke patients' condition remains stable, but they also have different degrees of consciousness disorder, dysphagia, nasal feeding diet, and like to eat digestible fruit juice, thick rice soup, soybean milk, milk and fresh vegetable juice in equal parts of 5-6 1000-2000 ml. Fruit juice mixed with milk should not be overheated, and it is advisable to cool it to 37℃-39℃. 600 ml fresh milk, 350 ml thick rice soup, 2 eggs, 50 g white sugar, 10 g sesame oil, 3 g salt mixed milk. Step 3: (1) Knock the eggs clean, put them in a clean container, add sugar, salt and oil, and stir them evenly with chopsticks; (2) 600 ML 350 ml fresh milk and rice soup are mixed and boiled; (3) Pour the prepared egg liquid into the cooked milk rice soup, face down, and stir with chopsticks to obtain 1000 ml mixed milk. The protein eggs in 1000 ml mixed milk weigh 40 grams, fat 40 grams, carbohydrate 120 grams, and 4 184 kilojoules (1000 kilocalories). Sugar for diabetes.
If stroke patients are mentally sound, but sometimes they choke people to eat a pasty diet, you should consider their diet, steamed egg soup, thick porridge and rotten noodles, minced meat and vegetables and lotus root starch, jam milk or food masher to mash food for patients.
It is not difficult for stroke patients to swallow vegetables during recovery period, so they should be light, less greasy, soft and balanced. Digestion.
The first is animal fat, such as lard, butter and cream, and foods with high cholesterol, such as egg yolk, roe, animal viscera and fat. , should be limited, because the saturated fatty acids in these foods can significantly increase the concentration of cholesterol in the blood, and converted into bile, promoting atherosclerosis. Vegetable oils, such as soybean oil, tea oil, sesame oil and peanut oil, contain unsaturated fatty acids, which can promote cholesterol excretion and reduce cholesterol in blood.
Secondly, we should eat more and more protein in our diet, and eat more egg white, lean meat, fish and various beans and bean products to provide leucine for our body. Milk factor and orotic acid contained in blue milk and yogurt every day can inhibit the synthesis of cholesterol in the body and reduce cholesterol in fat and blood. Delete the blue milk skin. Beans and soybean steroids promote cholesterol outflow.
You should eat more fresh vegetables and fruits containing vitamin C. Potassium, magnesium and vitamin C can lower cholesterol and enhance blood vessel density. In order to prevent bleeding, potassium, magnesium and Tibetan have protective effects.
You can eat more foods rich in iodine, such as kelp, seaweed and shrimp skin. Iodine can reduce the deposition of cholesterol on the arterial wall and prevent the occurrence of atherosclerosis.
V 6 grams of salt is suitable for human body to ingest too much salt, which contains a lot of sodium ions, which increases blood volume, heart burden, blood viscosity and hypertension, and has a negative effect on stroke patients.
Sixth, avoid alcohol, tea, coffee, spicy spices and other foods that stimulate the nervous system. In addition, eating less chicken soup and broth helps to protect the cardiovascular system and nervous system, and it is also necessary to avoid overeating.
Stroke patients generally choose the following supplementary diet prescription: 6 grams of auricularia auricula, soaking in water, adding vegetables or steaming. Lowering blood pressure, resisting thrombosis and platelet aggregation. 10 day, 25 celery, jujube soup, jujube soup, the role of lowering blood cholesterol. Eat fresh hawthorn or hawthorn soaked in boiling water, add appropriate amount of honey, and take it cold when tea has stroke complicated with diabetes, not honey. 4。 Raw garlic or onion10-15g fat, and enhance the effect. Fibrin activity and arteriosclerosis. 5- 10 ml vinegar softened blood vessels after meals in stroke patients.
Sequela of apoplexy-rehabilitation measures
The treatment of patients with cerebral hemorrhage has saved some lives, but the sequelae of left hemiplegia, especially in the hands of patients, are always broken like fists. Our ancestors reached out and pressed the patient's fingernails seven or eight times. If the daily pressure is high, even if the economic recovery is not as good as that of the original players, there is no problem in free promotion.
The specific method is: when performing, the root of thumb affects the hand of the patient. Ask for permission to press the nail root into the meat, find a good position, gently press the hard patient's finger and stretch it out for no more than 30 seconds, plus a better idea. The cerebral vessels and meridians of performers and patients are unobstructed. "Press the nail roots of the middle finger and thumb in the pressing sequence, the finger is straight, the nail roots of the index finger and the nameless nail, and the nail roots of the small nail are pressed three times before and after, and finally repeatedly pressed: press (Sun Hongde, Changling County, Jilin Province)
Patients with cerebral hemorrhage should pay attention to the following points: psychological nursing BR/& gt；;
(L): In the acute phase, family members are concerned about saving lives, while in the recovery process, patients' ability is often eager to restore their functions, requiring them to take care of themselves quickly and even go to work. New drugs and methods are needed to treat many patients who show pessimism, despair and depression. Therefore, patients should be encouraged to establish confidence in overcoming diseases, and disabled people should be encouraged to use Zhang Zhijian nonwoven parameters to treat diseases and reality, and strive to achieve a good prognosis, as well as medical staff, relatives, and * * * to overcome diseases. "When it comes, it's safe, otherwise, eager to fight for more harm, easy to get impatient.
(2) Pay attention to rational drug use. Patients often suffer from various diseases and symptoms. No relatives, friends or family members of the original prescription drugs. In addition, there are too many drugs and the medication is too messy. What can stomach, liver, kidney and hematopoietic system cause? To the side effects, not only can not speed up the recovery, but may lead to other problems.
(3) Preventing the recurrence of stroke is of great significance in the process of rehabilitation. Stroke is a sudden recurrence, and the number of attacks, mortality and prognosis of each sequela are also significantly increased. In order to prevent recurrence, we should pay attention to whether blood pressure is stable, proper intake, heart, lungs, and whether there are complications.
/& gt； (4) Family rehabilitation: The rehabilitation period is generally spent at home, and families should learn how to do it well. Family rehabilitation is the main therapeutic drug.
(5) Precautions: Rehabilitation care: including psychological care, basic care of aphasia, ensuring patients' basic needs according to patients' condition, and professional services, such as feeding tube and catheter bedsore care.
BR/(6) In order to ensure proper nutrition intake, patients are often accompanied by improper expression of wishes, or difficulty in coughing and swallowing, so it is impossible to ensure insufficient or excessive intake. Family members should pay enough attention to it. Formula group, due to supply, nasal feeding once when necessary.
(7) Smooth stool: constipation, too hard stool will cause hemorrhagic cerebrovascular disease and cerebral embolism. Keep the stool smooth and defecate regularly, celery, carrots and fruits. Provide necessary drugs, such as hot water senna Runchang pills and fruit guide.