With the arrival of the cold snap and the sudden drop in temperature, the number of patients suffering from stroke, commonly known as “stroke”, has increased greatly. However, the increase in the number of stroke patients has been met with a delay in treatment. The majority of patients are sent to hospital in the morning and afternoon, or the day before the onset of the next day, and this delay is costing them and their families a lot of money. 1, the current situation is gradually to the young “close” “Stroke is an acute cerebrovascular disease, divided into hemorrhagic stroke and ischemic stroke, ischemic stroke in China is the main.” Ischemic stroke is mainly manifested as cerebral thrombosis and cerebral embolism, while hemorrhagic stroke is manifested as cerebral hemorrhage due to intracranial hemorrhage, mainly caused by high blood pressure and arteriosclerosis, which usually has an acute onset and serious condition, with a death rate of more than 50%, and patients and families can easily detect the disease. Han Xiong, Department of Neurology, Henan Provincial People’s Hospital “The relationship between age and stroke is very close, as age increases, the degree of atherosclerosis becomes more severe and the incidence of stroke tends to increase, the stroke rate in people over 70 years old is 20 times higher than that in people under 50 years old.” Cardiovascular disease has been considered a disease of the elderly in the past, but it seems that the trend of younger age of onset has come to the fore, “clinical studies have shown that the rejuvenation of cardiovascular disease, in addition to genetic factors, is also related to factors such as excessive work pressure and poor lifestyle among young and middle-aged people, and drinking, smoking, staying up late and lack of exercise are recognized ways of life that damage the body “. ”In terms of gender, there are more men than women.” Yuan Xueqian said the reason may be related to the fact that more men than women have high blood pressure, smoke and drink alcohol, and that men are relatively more stressed in society and in the family, and have a relatively increased risk of stroke. ”At the top of the list of modifiable risk factors is hypertension.” Han Xiong said that more than 70 percent of patients with cerebral infarction and more than 90 percent of patients with cerebral hemorrhage have combined hypertension, “In addition, obesity, hyperlipidemia, hyperglycemia, hyperhomocysteinemia, cardiac arrhythmia, heart valve disease, excessive tobacco and alcohol addiction, short temper, low physical activity, and congenital cerebral artery malformation are all in the risk range.” 2. Unfortunately, less than one adult seeks medical attention in time “Generally speaking, the ‘golden time’ for thrombolytic treatment of cerebral infarction is within six hours of onset.” Han Xiong said, but in the clinic, those who can get to the hospital in 3 to 6 hours are very few, less than 10% of the whole cerebrovascular accident cases. ”The reason is simple: people’s lack of knowledge about stroke prevention and control, it is easy to ignore the symptoms of transient dizziness, numbness of the limbs, blurred vision and so on, and wait until half of the body can’t move before rushing to the hospital.” Han Xiong said, once more than 6 hours, thrombolysis not only can not dissolve the occluded blood vessels, save the already dead brain cells, but also risk causing brain hemorrhage, and eventually the patient lost the best time to rescue. ”Immediately after finding a patient with a sudden acute stroke, call 120 for help, do not put down the phone if necessary, ask and follow the doctor’s instructions for treatment.” While waiting for emergency vehicles to arrive, giving patients indiscriminate antihypertensive medication, unprofessional handling, pinching or making patients lie flat on their backs are all very wrong methods of first aid. ”Before waiting for the arrival of emergency personnel, the patient should be placed smoothly and kept quiet. Avoid shaking and tapping the patient, especially the head.” Many patients will feel difficulty in breathing and need to gasp for air, at this time do not pinch the patient’s human center, otherwise it will affect breathing, “When the patient appears to vomit, do not lie flat on your back to prevent vomit from being inhaled into the trachea by mistake; the flat position will make the patient’s tongue root fall back and block the throat causing asphyxia. Therefore, patients should be made to lie with their heads to the side or on their sides.” 3. Screening Rush screening with risk factors “There used to be 8 risk factors for stroke, but now it is refined to ‘4+12′.” Wang Xinzhi, chief physician of the Department of Neurology at the First Affiliated Hospital of Henan College of Traditional Chinese Medicine, said that of the newly refined 4 major risk factors and 12 general risk factors, if two major risk factors are met, or if one major risk factor and more than two general risk factors are met, or if there has been a previous stroke/transient ischemic attack, you should be screened for stroke. ”The four major risk factors were hypertension, hyperlipidemia, diabetes mellitus and age over 50 years.” The 12 general risk factors: atrial fibrillation, heart disease; sleep apnea; family history of stroke; smoking; heavy alcohol consumption; lack of exercise; excess dietary fat; obesity; being male; frequent bleeding gums, loose and dislodged teeth; ischemic eye disease and sudden deafness. ”The correct procedure for screening is to do a risk factor assessment at the stroke clinic and then, if necessary, routine blood work, ten blood biochemistry tests, homocysteine, four coagulation tests, sedimentation, glycated hemoglobin, and cerebrovascular ultrasound and electrocardiogram.” After the check, if needed, cerebrovascular CT, MRI, cerebral angiography, etc. were done. ”Combining the two screenings, patients diagnosed with a high risk of stroke and a high risk factor are subject to pharmacological intervention and life coaching, while those with a lower risk factor can just have their diet and exercise adjusted.” Patients diagnosed as high risk for stroke are reviewed regularly, “once every 3 months for general patients and once every half month or once a month for patients receiving pharmacological intervention.” ”Strokes due to carotid stenosis account for about 22% of ischemic strokes in developed countries.” Carotid artery stenosis over 70% is severe stenosis and should be intervened as soon as possible. It is recommended that people at high risk of stroke have an ultrasound examination of the carotid artery once a year. 4. Be alert Common aura manifestations should be kept in mind “Some people say that stroke is an emergency and there is no way to prevent it, in fact, the onset of stroke usually has some aura manifestations.” There are 6 common aura of stroke: sudden onset of numbness and weakness in the face, upper and lower limbs or unilateral limbs; sudden speech difficulty, or loss of comprehension; blurred vision in front of the eyes, black hazy double shadow; balance adjustment disorder or difficulty in walking; sudden vertigo, feeling that all immobile things are shaking; sudden intense headache that lasts for more than 1 hour. ”It’s worth mentioning the immediate diplopia. When we are too tired or use our eyes too much, or even when we suddenly get up, we may feel that things in front of us become double shadows.” “If you cover one eye and find that the vision becomes normal, you should alert yourself at this time whether it is an early symptom of stroke, with a view to early detection and treatment.” ”There is a certain pattern in the time of year when strokes occur, with the winter and spring cold seasons being the most prone and the highest incidence between 6 a.m. and 11 a.m. during the day.” Wang Xinzhi said that because the temperature drops in winter, the level of adrenaline in the human body rises, the body surface blood vessels will contract to reduce the distribution of heat, while adrenaline can make the heart rate accelerate, cardiac output increases, metabolism accelerates, blood pressure rises, resulting in enhanced platelet activity and rising blood viscosity, which is very likely to induce stroke. ”People with a family history of stroke, hypertension, diabetes, heart disease and cerebral atherosclerosis patients should be vigilant at the change of seasons.” Obesity, hyperlipidemia, excessive tobacco and alcohol addiction, short temper, low activity, congenital cerebral artery malformation and cervical spondylosis with frequent vertigo attacks are also at risk. 5. Rehabilitation The role of family members is crucial “Many patients’ habits change after the initial stroke, and it is important to return from large fish and meat, high sugar and oil to a light, easy-to-digest, protein-rich diet, and to limit animal fat and cholesterol-rich foods.” Wang Xinzhi reminded that both smoking and alcohol are high-risk factors for triggering atherosclerosis, and if you continue to drink and smoke, atherosclerosis will progress to occlusion based on the original stenosis, “drinking is very likely to cause brain hemorrhage, especially in people who have already had a stroke, and a second stroke can be fatal.” ”Family members play a vital role in the rehabilitation and prevention of recurrence in stroke patients, and it is important to try to keep patients cheerful and take care of them in terms of life.” If available, patients should be given appropriate exercise, such as walking, or doing exercises in bed, and slow walking and swimming if their strength recovers well. ”Patients with stroke hemiplegia can undergo physical rehabilitation training after the danger period, and it is better to do it early than late.” Under the guidance of a doctor, rehabilitation training should include language training and passive movement of the affected limb, encouraging the patient to use the healthy limb to help the affected limb to prevent muscle atrophy or joint ankylosis of the paralyzed limb, “Family members should carefully observe changes in the condition, and when they find that the patient’s mental, language or functional impairment of the affected limb is getting heavier, they should promptly ask the doctor for treatment “. Almost all stroke patients have varying degrees of anxiety or depression. Families should enhance communication with patients to reduce their bad mood and keep abreast of their emotional changes, and seek medical help for psychological or pharmacological treatment if necessary. 6, prevention Reasonable diet and proper exercise are key “To prevent strokes and other cardiovascular diseases, it is usually advisable to eat light, dietary fiber-rich food, and it is advisable to use cooking methods such as steaming, boiling, stewing, stir-frying, stir-frying and warming, and it is not suitable for frying, deep-frying, stir-frying, drenching and baking.” Han Xiong said, in addition to a reasonable diet, a reasonable amount of exercise is also a key part of stroke prevention. Moderate exercise can lower blood lipids, control blood sugar and stabilize blood pressure levels, as well as raise the beneficial components of blood lipids, which can help prevent strokes. Studies have shown that there is a relationship between vitamin D and the onset of stroke, and when the body does not consume enough vitamin D, the risk of stroke increases. Food is an important source of vitamin D. Common foods rich in vitamin D include milk, egg yolk, cod liver oil, mushrooms, etc. “You can also get vitamin D by sunbathing. In autumn and winter, when the weather is not too cold, expose your face, neck and forearms to the sun for an hour to replenish vitamin D. You can also walk around in the sun.” . ”With active control of modifiable risk factors, it is entirely possible to prevent and delay the occurrence of stroke.” Patients with underlying diseases such as hypertension, diabetes and hyperlipidemia should be actively treated under the guidance of a doctor, avoid factors such as tension, excitement, worry, mental or physical overwork, and pay attention to the influence of objective circumstances such as sudden changes in temperature and changes in living habits, and “develop reasonable dietary habits, advocate low sodium, low cholesterol and low fat foods for the middle-aged and elderly, and diversify the side dishes The diet should not be too full or too hungry”.