1.Thrombolytic therapy: that is, within 3-6 hours after the onset of the disease. Thrombolysis can be administered intravenously or arterially, and arterial thrombolysis is not widely used in clinical practice. Commonly used drugs include urokinase and fibrinogen activator (t-PA). The main risk and side effect of thrombolytic therapy is intracranial hemorrhage, and the chance of cardiogenic embolism brain hemorrhage is higher.
2, anticoagulation therapy: commonly used drugs are heparin, low-molecular heparin, and coagulation test must be made. The main side effect is bleeding, of which low-molecular heparin is safer than ordinary heparin.
3.Anti-platelet drugs.
(1) Aspirin, is the economic, affordable, safe and most conventional anti-platelet prophylactic drug, the minimum effective dose is 50mg or 75mg/day. The dose can be increased to 300mg/day in the acute phase. No hematologic testing is required for administration. Enteric aspirin can significantly reduce side effects.
(2) Diazepam, which can be used as a therapeutic and prophylactic drug, is administered at a dose of 125-250 mg/day orally with meals. Blood picture, liver function and blood clotting should be tested during the course of drug administration. A few patients may experience side effects such as granulocytopenia, jaundice and elevated aminotransferases, prolonged bleeding time. Use with caution in ulcer disease, thrombocytopenia and bleeding disorders. The price of this drug is more expensive than aspirin.
(3) Clopidogrel: Europe and the United States has begun to use, the drug 75mg and against Clopidogrel 250mg of the same efficacy.
4.Fiber-lowering therapy: the effect is to increase the activity of the fibrinolytic system and inhibit thrombus formation, commonly used drugs are fibrin-lowering enzyme, Dongling pure clotrimase and pit viper antithrombin, etc.. Use within 24 hours of the onset of disease. Fibrinogen should be detected in the process of medication.
5.Hemodilution therapy: The purpose is to reduce blood viscosity, improve microcirculation and replenish blood volume deficiency, commonly used drugs include low molecular dextrose and 706 plasma substitute.
6.Cerebroprotective agents.
(1) Calcium antagonists: stop intracellular calcium overload, prevent vasospasm and increase blood flow. Commonly used drugs include nimodipine, nicardipine, flunarizine hydrochloride and cerebrolysine.
(2) Cytidylphosphorylcholine: has the effect of stabilizing cell membrane.
(3) Glutamate antagonists and GABA enhancers.
(4) Others: vitamin E, vitamin C and mannitol
alcohol also have antioxidant and free radical scavenging effects.
7.Chinese herbal medicine: acupuncture and massage treatment.
8.Rehabilitation: It is the main method of treatment for cerebrovascular disease abroad, and systematic, standardized and individualized rehabilitation treatment is usually carried out from 3 to 7 days after the onset.
9.General treatment.
(1) adjust blood pressure, cerebral infarction should be used with caution antihypertensive drugs, such as blood pressure of 150 ~ 160/100 do not need to use antihypertensive drugs. Too low a blood pressure drop can aggravate cerebral ischemia.
(2) Keep respiration unobstructed, and give oxygen and tracheotomy if necessary to those who have difficulty in breathing.
(3) Reduce intracranial pressure and cerebral edema. Cerebral edema can occur in acute cerebral infarction, especially in large areas, and is a common cause of death within 1 week after the onset. Mannitol should be used to reduce intracranial pressure, and glycerol fructose and tachyphylaxis can be used for abnormal renal function.
(4) Prevent and treat respiratory and urinary tract infections, and apply antibiotics reasonably.
(5) Prevent pulmonary embolism and deep vein thrombosis of the lower extremities by subcutaneous injection of low molecular heparin or heparin preparations.
(6) Prevent the formation of decubitus ulcers by early activity, turning and patting the back every 2 hours and moving the paralyzed limb passively. Avoid pressure and bedsore formation.
(7) Enhance nutrition. According to the patient’s specific condition, nasal feeding and intravenous high nutrition should be performed to give the patient a chance to recover.