Rehabilitation of patients with cerebral hemorrhage

(I) Acute stage. 1, internal medicine treatment: (1) general treatment: ① quiet bed, elevated head of the bed, keep the airway open, turn over regularly, fold the back to prevent pneumonia, bedsores. ② For those who are agitated or epileptic, apply sedative, antispasmodic and analgesic drugs. (③ head cooling, with ice cap or ice water to reduce brain temperature, reduce intracranial metabolism, help reduce cerebral edema and intracranial hypertension. (2) Adjust blood pressure: for those with elevated blood pressure, intramuscular injection of lisinopril 1mg can be repeated if necessary, such as awake or nasogastric can be taken orally with compound antihypertensive tablets 1-2 tablets 2-3 times / d, blood pressure maintained at 20.0-21.3/12.0-13.3kpa or so is appropriate. (3) Reduce intracranial pressure: after cerebral hemorrhage and cerebral edema, about 2/3 of them have increased intracranial pressure, it is extremely important to actively reduce intracranial pressure and block the above pathological process. The following drugs can be used: ① dehydrating agent: 20% mannitol or 25% sorbitol 250 ml in 30 minutes, according to the condition of every 6-8 hours once, 7-15 days for a course of treatment. ② diuretics: 40 ~ 60mg dissolved in 50% glucose solution 20 ~ 40ml static injection. (4) Pay attention to calorie supplementation and water, electrolyte and acid-alkaline balance. (5) Prevention and treatment of complications. Surgery: Craniotomy to remove hematoma or hematoma puncture therapy is aimed at eliminating hematoma, relieving pressure on brain tissue, effectively reducing intracranial pressure, improving cerebral blood circulation in order to save the patient’s life and help recovery of neurological function. (The main purpose of treatment is to promote the functional recovery of paralyzed limbs and speech disorders, improve brain function, reduce sequelae and prevent recurrence. 1. Prevent high blood pressure and emotional excitement, and avoid re-bleeding. Life should be regular, diet should be moderate, and stools should not be dry. 2.Functional exercise: after the condition of mild cerebral hemorrhage or severe cases improves, passive activities and massage of paralyzed limbs should be carried out in time, 2-3 times a day, about 15 minutes each time, and the amount of activities should be changed from small to large, and the activities should be carried out from lying down in bed, and then gradually sitting up, standing up and supporting walking. For speech disorders, pronunciation and speech should be practiced. When the muscle strength is restored to a certain degree, the practice of life function and occupational function can be carried out to gradually restore the ability to live and labor. 3.Drug therapy: drugs to promote neurometabolism can be used, such as cerebral fukang, cytidyphosphorylcholine, cerebral viability, r-amyl caseinate, coenzyme Q10, vitamin B, vitamin E and vasodilator drugs, etc. Chinese traditional medicine formulas to activate blood circulation and remove blood stasis, benefit qi and collaterals, nourish the liver and kidney, and dissolve phlegm and open up the mind can be used as well. 4.Physiotherapy, body therapy and acupuncture.