Stroke is the scientific name for a stroke, which is a sudden onset of cerebral blood circulation disorder. The clinical manifestations are sudden fainting, unconsciousness or sudden onset of distorted eyes and mouth, hemiplegia, strong tongue and speech, and mental retardation. Stroke includes ischemic stroke (transient ischemic attack, atherosclerotic thrombotic cerebral infarction, lacunar cerebral infarction, cerebral embolism), hemorrhagic stroke (cerebral hemorrhage, subarachnoid hemorrhage), hypertensive encephalopathy and vascular dementia.
Stroke poses a great threat to human health and life, causing great suffering to patients and a heavy burden to families and society. Therefore, it is imperative to fully understand the seriousness of stroke, improve the level of stroke treatment and prevention, and reduce the incidence, disability and mortality of stroke. Stroke prevention, stroke control factors, stroke can be prevented.
Knowing the seriousness of stroke, early prevention and treatment of stroke is particularly important. Understanding the risk factors of stroke and giving certain interventions and treatments can prevent and reduce the occurrence of stroke and reduce the disability and mortality rates.
Risk factors for stroke
1, hypertensive disease, whether hemorrhagic stroke or ischemic stroke, hypertension is the most important independent risk factor. Gradually reduce blood pressure to below 140/90mmHg through antihypertensive drugs and low salt diet.
2, diabetes mellitus, through controlled diet, glucose-lowering drugs, to reduce blood sugar to 3.9-6.1mmol/L normal range.
3, heart disease, such as rheumatic heart disease, coronary heart disease. Especially to prevent atrial fibrillation caused by embolism dislodged causing brain embolism.
4, lipid metabolism disorders, very low density lipoprotein, low density lipoprotein is the most important lipoprotein that causes atherosclerosis, high density lipoprotein is anti-atherosclerotic lipoprotein.
5, transient ischemic attack (TIA), TIA itself is a type of ischemic stroke classification, can also be a precursor or anterior area symptoms of cerebral infarction, should be treated promptly.
6.Smoking and alcohol abuse.
7, blood rheology disorders, especially the decrease of cerebral blood flow when the viscosity of whole blood increases, in which the increase of erythrocyte ratio and the increase of fibrinogen level are the main risk factors of ischemic stroke.
8, obesity, obesity and overweight are risk factors for ischemic stroke, not related to hemorrhagic stroke.
9, age and gender, age is an important risk factor for atherosclerosis, the degree of atherosclerosis increases with age, the incidence of stroke increases with age above 50 years old, and in recent years, the incidence of stroke in young and middle-aged people has also increased, which should not be ignored. In general, the incidence of stroke is lower in women than in men.
Primary prevention of stroke
Every person over 35 years of age who does not have cerebrovascular disease should be educated on the following.
1. Know your blood pressure. Have it measured at least once a year. If it is elevated, work with your doctor to control it in the normal range. Elevated blood pressure (hypertension) can cause strokes. You can have your blood pressure checked at the hospital, community, pharmacy, or at home with an automatic blood pressure monitor. If your high pressure (systolic) is consistently greater than 135 or your low pressure (diastolic) is consistently greater than 85, see your doctor.
If your doctor confirms that you have high blood pressure, he may recommend changes in your poor diet, proper exercise and medication. Medications to control high blood pressure have improved greatly. Once you and your doctor have found the right medication for you, there are few side effects and it will not affect your quality of life.
2. Know if you have atrial fibrillation. Atrial fibrillation is an irregular heartbeat that alters the normal function of the heart and makes it easier for certain components of the blood to collect in the atria. The irregular heartbeat causes these components to be dislodged and travel throughout the body with the blood, causing strokes. Doctors can diagnose atrial fibrillation by counting the pulse.
In the hospital, atrial fibrillation can be confirmed or ruled out by an electrocardiogram. If you have atrial fibrillation, to reduce the risk of stroke, your doctor will usually put you on some oral medication such as warfarin or aspirin.
3. If you smoke, quit it. Smoking doubles the risk of stroke. If you start to stop smoking today, your risk of stroke will start to go down immediately.
4. If you drink alcohol, keep it moderate. Current research shows that 2 drinks a day can reduce stroke by 50%. But more than 2 drinks increases the risk of stroke by 3 times and causes liver disease, traffic accidents and more. If you drink alcohol and find it very difficult to stop drinking, take note of the following.
(1) Do not drink too much, determine an appropriate amount (for example, 1 beer or 2 small glasses of white wine) and follow it carefully.
(2) Drinking at home is easier to control the amount than drinking outside.
(3) Determine 2 to 3 days a week when you will not drink alcohol.
(4) Choose fish and other protein-rich dishes to drink.
(5) Do not drink continuously, drink some water or tea to reduce the amount of alcohol you consume. If you don’t drink alcohol, don’t try it! Remember that alcohol is also medicine, it can interact with some drugs and affect their absorption. It is best to ask your doctor or pharmacist if the medication you are taking interacts with alcohol.
5. Know if you have high cholesterol. Know the indicator of your cholesterol. If your cholesterol is high, it can increase your risk of stroke. Lowering elevated cholesterol will lower the risk of stroke. High cholesterol can be controlled with a moderate diet and exercise. Some people also need medication.
6. If you have diabetes, follow your doctor’s advice carefully to control your blood sugar. Diabetes can be controlled if you pay careful attention to what you eat and drink. Work with your physician to develop a nutrition plan that fits your needs and lifestyle. Your doctor may change some of your poor lifestyle and prescribe medications to help you control your blood sugar. Elevated blood glucose increases the risk of stroke; controlling blood glucose decreases the risk of stroke.
7. Participate regularly in your favorite physical activities in your daily routine. Walking briskly for at least 30 minutes a day can improve your health in many ways and can reduce stroke. Exercising with a friend can make it easier for you to keep going. If you don’t like walking, choose another sport that fits your lifestyle: cycling, golf, swimming, dancing, ping pong, or any kind of aerobic activity. Make sure you have some time to be active every day.
8. Enjoy a low-salt, low-fat diet. By reducing the intake of salt and fat in your diet, you can lower your blood pressure and, more importantly, reduce the risk of stroke. Maintain a balanced diet each day: adequate fruits, vegetables, and cereals, and moderate amounts of protein. Adding fiber such as whole wheat bread and cereal products, raw, unpeeled fruits and vegetables, and dried beans can reduce cholesterol by 6 to 19%.
9. Ask your doctor if you have a circulatory disorder, which can increase the risk of stroke. Strokes can be caused by problems with the heart (pump), arteries and veins (pipes), or when blood flows through them. Together, these make up the circulatory system. Your doctor can detect problems with the circulatory system that supplies your brain by examining Fatty deposits – caused by atherosclerosis – can block arteries and keep blood from being transported from the heart to the brain.
These arteries are located on either side of the neck and are called the carotid and vertebral arteries. This blockage, if left untreated, can lead to a stroke. You can have your doctor check for these problems by listening to an arterial murmur, just like you would listen to your heart, or by doing an ultrasound or MRI. If you have blood problems such as sickle cell disease, severe anemia, or other conditions, work with your doctor to address these problems. If left untreated, it can lead to a stroke.
Circulatory disorders can usually be treated with medications. If your doctor prescribes medications such as aspirin, warfarin, ticlopidine, clopidogrel, pentoxifylline, or other medications for circulatory disorders, take them as prescribed. Sometimes, surgery may be needed to resolve a circulatory disorder, such as arterial stenosis.
10. If you have any stroke symptoms, seek immediate medical attention.
Secondary prevention of stroke
After a stroke has occurred, it is important to identify and treat its important causes and stroke risk factors.
The aim of secondary prevention is to prevent or reduce the risk of another stroke, which is most important for all TIAs, reversible strokes. Patients with an initial TIA or mini-stroke are at risk for a second stroke, which is likely to occur within two weeks of the initial stroke, especially if the initial stroke is due to an embolus originating from a heart or carotid artery stenosis. Secondary strokes can lead to severe disability. Therefore, finding and treating the cause of the TIA or stroke and preventing a second, more severe stroke is imperative, and this is especially important in the young stroke population (<50 years).
1. Components of stroke treatment that should be available to patients and families in hospital
(1) Prehospital treatment is the basis for providing timely stroke care. It is important to promote awareness of the importance of treating patients and families immediately after the onset of stroke symptoms;
(2) Patients with TIA are at great risk because they are not aware that TIA is the most important risk factor for cerebral infarction. 10% of patients with TIA have a stroke within 1 month. Therefore, patients should be educated about the importance of TIA. Take appropriate medication to prevent recurrence of stroke;
(3) The 6 most important signs of stroke. If the above signs and symptoms last for more than 10 minutes, the patient should immediately call the emergency number or go to the nearest emergency room immediately;
(4) It is important to educate patients about the importance of timely thrombolysis in the event of stroke;
(5) emphasize that stroke is a medical emergency and that it is important to get to the hospital as early as possible;
(4) Stroke risk factors that the patient can prevent;
(5) Methods of rehabilitation training for patients with hemiplegia and speech disorders and medical institutions that can provide rehabilitation services.
2.Care knowledge for family members
(1) Psychological care Patients with cerebrovascular disease need to be taken care of because they are paralyzed in bed and have difficulty moving around. This psychological state seriously affects the treatment and recovery. Therefore, the patient’s family should grasp the patient’s psychological reaction, timely guidance, communication and talk, so that the patient can experience the warmth of the family, help the patient to establish confidence in overcoming the disease, which will help the patient to actively cooperate with the treatment, affectionate care is a necessary condition for psychological recovery.
(2) Diet care
① Restrict total calories and control body weight in the standard or near standard weight range;
② Reduce the intake of saturated fatty acids and cholesterol;
(3) Limit the daily salt intake;
④ Avoid strong tea, coffee and spicy food;
⑤ Quit smoking and limit alcohol.
(3) Ensure appropriate amount of protein, especially high-quality protein: such as lean meat, fish, eggs, etc.; eat more vegetables and fruits; supplement vitamins and minerals: such as vitamin C, vitamin B6, vitamin E, etc.
(4) Care of urinary catheter and gastric tube
Urinary catheter.
①Teach the family to change the urinary catheter regularly, and contact the community health service if necessary;
②Teach family members to release urine regularly and keep local cleanliness to avoid infection;
③ Pay attention to the color of urine and seek medical attention in time if abnormalities are found.
Gastric tube.
①Change the gastric tube regularly, and contact the community when necessary;
②Teach family members to feed and pay attention to dietary hygiene;
(3) Pay attention to any abnormalities and seek medical consultation promptly if abnormalities are found.
(5) Skin care
①Turn over regularly and move gently to avoid damaging the skin;
②Keep the bed unit clean, flat, and free of foreign bodies and debris;
(3) Keep the patient’s skin clean and avoid all kinds of stimulation;
④The early stage of pressure sores should be treated promptly to avoid their development;
⑤ Pay attention to increase nutrition and improve the patient’s resistance;
⑥Take medication on time and review regularly.
Cerebrovascular disease is prone to recurrence, and the more times it occurs, the more serious the disease is and the more serious the sequelae are. Therefore, it is especially important to prevent recurrence of cerebrovascular disease. Hypertension, diabetes mellitus and hyperlipidemia are risk factors of cerebrovascular disease, and patients with cerebrovascular disease with these diseases should be treated actively.
①Adhere to the anti-hypertensive drugs to keep the blood pressure in the normal range, and it is better to bring your own blood pressure monitor;
②Adhere to taking glucose-lowering drugs, and regularly review blood sugar and urine sugar. Insist on taking lipid-regulating drugs;
③Patients with cerebral infarction should take anti-platelet coagulation drugs such as enteric aspirin for a long time;
④ Review the outpatient clinic two weeks after discharge or seek medical consultation at any time if abnormalities are found.
3.The rehabilitation knowledge that patients and families should master
The aim of stroke rehabilitation is to help stroke patients achieve the best possible recovery. It is important to help stroke patients and their families to achieve the best possible recovery. The best recovery can only be achieved if stroke patients and their families work together.
(1) Natural recovery occurs in most patients. Soon after stroke, some lost function will begin to return. Recovery is fastest in the first few weeks, but sometimes lasts for a long time. During natural recovery, many patients will develop abnormal postures;
② Rehabilitation is another part of the treatment. It helps the patient to maintain and regain some of the lost functions in order to live more independently. Early rehabilitation is very important to a patient’s recovery and usually begins while the patient is still in the acute phase of treatment. For many patients, rehabilitation is a long-term process;
③ Understand the patient’s suitability for rehabilitation;
④Understand the basic methods of rehabilitation and proceed in a gradual manner even after the patient is discharged from the hospital;
⑤ The need for the patient and family to actively cooperate with the rehabilitator in the rehabilitation process.