Traditional Culture Encyclopedia - Weather inquiry - Sequela of cerebral hemorrhage
Sequela of cerebral hemorrhage
Etiology of sequelae of cerebral hemorrhage
1, winter and autumn are more common than summer. This is because the winter weather is cold, blood vessels contract and blood pressure rises, while the summer weather turns hot, blood vessels dilate and blood pressure drops. However, heatstroke and increased sweating in summer will also promote the sequelae of cerebral hemorrhage.
2, emotional excitement will also make blood pressure suddenly rise, causing sequelae of cerebral hemorrhage.
3. Excessive fatigue and overexertion will cause blood pressure to rise and become the inducement of sequelae of cerebral hemorrhage.
4. Overeating and eating too greasy food will increase blood lipids, accelerate blood circulation and suddenly increase blood pressure, which can lead to sequelae of cerebral hemorrhage.
Generally, cerebral hemorrhage causes different degrees of brain tissue damage and brain dysfunction, although there are still different degrees of sequelae after treatment. This is related to the following factors:
(l) The amount of bleeding directly affects the severity of clinical symptoms. It is not difficult to understand that the amount of hemispheric bleeding above 25 ml often leaves sequelae. The more bleeding, the more serious the sequelae.
(2) Hemorrhage site: Hemorrhage in different parts has different degrees of brain function damage, such as basal ganglia hemorrhage, which often leaves serious limb dysfunction, while small bleeding lesions in brain stem often lead to death. Cerebellar hemorrhage can lead to numbness of limbs and unstable walking.
The bleeding or bleeding site in the non-functional area (that is, the static area) does not affect the motor and sensory pathways, so there is no damage to nerve function. Some patients have affected the motor and sensory pathways due to edema and focal compression, but they have not actually damaged their pathways. After treatment, edema was eliminated, compression was relieved and function was restored. Therefore, the bleeding site is related to the prognosis.
(3) The treatment and nursing in the rehabilitation period should be related to sequelae, but the severity of sequelae mainly depends on the size and location of the disease and the appropriate treatment measures in the acute stage.
Symptoms of sequelae of cerebral hemorrhage
Hemiplegia is the most common sequela of cerebral hemorrhage, characterized by muscle weakness, poor mobility or complete immobility of one limb, often accompanied by sensory disturbance of the ipsilateral limb, such as cold and heat, pain, etc., or complete unconsciousness. Sometimes it may be accompanied by ipsilateral visual field defect.
1, the most common sequela of cerebral hemorrhage is hemiplegia. Specifically, the muscle strength of one limb is decreased, and the activity is unfavorable or completely unable to move, often accompanied by sensory impairment of the ipsilateral limb, such as cold and heat, pain and other sensory loss or complete ignorance, and sometimes accompanied by ipsilateral visual field defect.
2.aphasia. Mainly including motor aphasia, patients can understand others' words, but can't express themselves. Sensory aphasia has no language expression disorder, but can't understand what others say and what they say. Named aphasia is characterized by seeing an object and being able to tell its purpose, but not its name.
3. Other manifestations of sequelae of cerebral hemorrhage include headache, dizziness, nausea, insomnia, inattention, tinnitus, dizziness, hyperhidrosis, gait instability, neck pain and fatigue, loss of appetite, memory loss and dementia.
4. External factors: climate change. Clinically, it is found that cerebrovascular diseases are particularly common in seasonal changes, such as the season at the junction of spring, summer, autumn and winter. Modern medicine believes that seasonal changes and changes in external temperature can affect the normal metabolism of human neuroendocrine.
5. Other symptoms of sequelae of cerebral hemorrhage include: headache, dizziness, nausea, insomnia, dreaminess, inattention, tinnitus, dizziness, sweating, palpitation, unsteady gait, neck pain, fatigue, loss of appetite, memory loss, dementia, depression, etc.
Examination of sequelae of cerebral hemorrhage
The method mainly includes the following points:
First, patients with large amount of bleeding have poor prognosis. Patients with hematoma formation and obvious displacement of midline structure have poor prognosis. Lumbar puncture with colorless and transparent cerebrospinal fluid has a good prognosis.
Second, the deeper and longer the coma, the worse the prognosis. 94% people who are in a deep coma die. Patients with post-illness disturbance of consciousness or gradual improvement of disturbance of consciousness have a better prognosis. The longer the sleepiness, the worse the prognosis.
Third, the older you get, the worse your prognosis is. The mortality rate under 60 years old is low, accounting for about 30%, and the mortality rate over 70 years old can be as high as 70%.
Fourth, the longer the history of hypertension, the higher the blood pressure and the worse the prognosis. When the blood pressure is above 26.6/16 kpa (200/120 mm Hg), the mortality rate is 30.07%.
5. The faster the disease progresses, the earlier the symptoms of intracranial hypertension appear, the heavier the performance and the worse the prognosis. The mortality rate of patients with optic papilla edema is 59%, and the earlier the optic papilla edema appears, the higher the mortality rate. Those who appeared within 3 hours after onset 1 0,000% died. Within 48 hours, 50% died. When the lumbar puncture pressure is above 200 mm Hg, the mortality rate is 64.5%.
6. The more acute and severe the onset, the higher or lower the blood pressure at onset, and the worse the prognosis.
Treatment of sequelae of cerebral hemorrhage
First, the treatment of dyskinesia
Rehabilitation treatment is very important for patients with sequelae of cerebral hemorrhage. The purpose is to change the symptoms such as numbness of limbs and unfavorable language, and achieve the best state; And reduce the high recurrence rate of rebleeding. Especially in the recovery of limb dyskinesia.
At present, it is believed that patients with limb dyskinesia caused by cerebral hemorrhage can obviously reduce or alleviate the sequelae of paralysis through formal rehabilitation training. Some people regard rehabilitation as particularly simple, even equivalent to exercise. They are eager for success, often get twice the result with half the effort, and lead to joint muscle injury, fracture, shoulder and hip pain, aggravated spasm, abnormal spasm pattern and gait, as well as foot drop and varus, which is called misuse syndrome.
Second, rehabilitation function exercise
1. Functional exercise of facial paralysis: use your thumb to pass through the eyebrow arch from the brow, through the temple to the corner of the eye, and then down through the alar, nasolabial groove, corners of the mouth to the mandibular angle, and slowly press and knead until it is sour and spicy.
2. Language function training: practice word for word patiently and carefully. When practicing, pay attention, keep emotional stability, speak slowly, and start with simple words and phrases. Encouraging patients to talk boldly with others is also a method of language training.
3, hemiplegia functional exercise:
1) Sitting and lying exercise: Family members help patients sit up and lie down repeatedly; Or tie a rope at the foot end of the bed, so that the patient can grasp the rope with healthy hands and do prone position training by himself.
2) Upper limb movement: the nursing staff (or family members) stand on the affected side of the patient and hold the wrist of the affected side with one hand; The other hand is placed slightly above the elbow joint to make the affected limb stretch and rotate up and down, left and right; The nurse holds the wrist of the affected limb with one hand and moves each finger with the other hand.
3) Functional exercise of lower limbs: hold the ankle joint of the affected limb with one hand, and hold the knee joint slightly below with the other hand, so that the hip and knee joint can stretch, bend, rotate inside and outside, adduction and abduction. Hold the arch of the affected limb with one hand, and do tiptoe exercise with the other hand. Patients can also practice walking by sitting on a stool to further help patients practice walking.
4) Exercise in daily life: The ultimate goal of home care is to help patients take care of themselves. Gradually train patients to eat, dress, wash, go to the toilet and some outdoor activities, from full care to assistance until they take care of themselves.
Diet of sequelae of cerebral hemorrhage
First, what food to eat for cerebral hemorrhage is good for your health:
1, eat more fresh vegetables and fruits because they contain vitamin C, potassium and magnesium. Vitamin C can lower cholesterol, enhance the density of blood vessels and prevent bleeding. Potassium and magnesium have protective effects on etiology and tube.
2, you can eat more foods rich in iodine, such as kelp, seaweed, shrimp and so on. Iodine can reduce the deposition of cholesterol on the arterial wall and prevent arteriosclerosis.
3. Drink mixed milk for a long time (600 ml of fresh milk, 350 ml of thick rice soup, 2 eggs, 50 g of sugar, 0/0 g of sesame oil/kloc, 3 g of salt).
In order to prevent constipation, you should eat more fiber-rich foods, such as vegetables, celery, leeks, fruits and so on.
5. Keep the body hydrated enough for blood dilution. Dinner should be light. Drink 1 ~ 2 cups of warm water before going to bed at night and when getting up in the morning.
6, diet should be properly supplemented with protein, often eat some egg white, lean meat, fish and all kinds of beans and bean products, to supplement the amino acids needed by the body.
Second, what food is best not to eat for cerebral hemorrhage:
1, animal fat, such as lard, butter, cream, etc. And foods with high cholesterol content, such as egg yolk, roe, animal viscera, fat meat, etc. , should be limited, because the saturated fatty acids contained in these foods can significantly increase the concentration of cholesterol in the blood and promote arteriosclerosis.
2, avoid eating cold food, because, after excessive cold food enters the gastrointestinal tract, it will suddenly stimulate the stomach, make blood vessels contract, raise blood pressure, aggravate the condition, and easily induce cerebral hemorrhage.
3. Limit fat intake. Reduce the total amount of fat in daily diet, reduce animal fat, and use vegetable oil instead of animal oil when cooking, such as soybean oil, peanut oil and corn oil. And limit the cholesterol in the diet to below 300 mg per day, which is equivalent to eating 3 egg yolks per week.
4, avoid high salt. Patients with cerebral thrombosis should have little salt, so they should take a low-salt diet, 3 grams of salt a day, add salt after cooking and mix well.
5. Limit the intake of refined sugar and sugary sweets, including snacks, sweets and drinks.
Prevention of sequelae of cerebral hemorrhage
The causes of cerebral hemorrhage are mainly related to the pathological changes and sclerosis of cerebral vessels. Vascular diseases are closely related to hyperlipidemia, diabetes, hypertension, vascular aging and smoking. Cerebral hemorrhage usually refers to spontaneous primary cerebral hemorrhage. Patients often have sudden onset due to emotional excitement and excessive exertion, showing aphasia and hemiplegia, and in severe cases, they are unconscious. More than half of the patients are accompanied by headache and vomiting. Therefore, in order to prevent the sequelae of cerebral hemorrhage, we should start from the following aspects:
First, we must control blood pressure: hypertension is a lifelong disease, so we should take medicine for life, and we should not fish for three days and dry the net for two days, so that blood pressure will rebound repeatedly, which will easily lead to blood vessel rupture and cerebral hemorrhage.
Second, life should be regular: winter is the season of storing essence. It is advisable to go to bed early and get up late, especially for the elderly. The adjustment function of the body is declining, so it is impossible to watch TV and stay up late like young people. Rest on time to ensure sleep, especially at noon, and it is best to have a two-hour lunch break. Old people can do what they can, but they should not be too tired.
Third, we should develop scientific eating habits: patients with hypertension should quit smoking and limit alcohol, advocate a low-salt and low-fat diet, and have a light and diverse diet. Eat whole grains, fish, beans, eggs, milk, lean meat and other foods rich in vitamins and minerals, as well as fresh vegetables and fruits.
Fourth, we must maintain a peaceful mind: a healthy mind is an important factor to prevent arteriosclerosis and hypertensive cerebral hemorrhage. Old people should avoid ecstasy, anger and strong stimulation. In particular, the elderly with cardiovascular and cerebrovascular diseases should be good at adjusting and controlling their emotions, and should not play stocks and mahjong to prevent sudden cerebrovascular accidents due to violent mood fluctuations.
5. Timely and correct rescue: Cerebrovascular accidents often have rapid onset, rapid progress, high disability rate and high mortality rate. Ensuring that patients get timely and correct treatment in prime time is the key to successful rescue.
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