1. Treatment principles: reduce intracranial pressure and control cerebral edema to prevent brain herniation, and reduce elevated blood pressure to prevent further bleeding. 2. Routine treatment (1) General treatment; ① Keep quiet and absolutely bed-ridden, and rescue should be carried out locally. Long-distance transportation and excessive movement are not suitable to avoid aggravating bleeding; ② Keep the respiratory tract open and suction out oral secretions or vomitus at any time . Give appropriate oxygen, preferably intermittently; ③Maintain nutrition, water and electrolyte balance. (2) Control cerebral edema and reduce intracranial pressure; (3) Control hypertension and reduce elevated blood pressure is an important measure to prevent further bleeding, but it is not advisable to lower blood pressure too low to prevent insufficient blood supply. Generally, it is appropriate to maintain it at 20.0￣21.3/12.0￣13.3kpa (150￣160/90￣100mmhg); (4) Hemostatic drugs and coagulation drugs have no effect on cerebral hemorrhage, but if combined with gastrointestinal bleeding or coagulation disorder , can still be used; (5) To prevent and treat complications, critically ill patients should especially strengthen basic care, gently change positions regularly, pay attention to dry and clean skin, prevent bedsores and lung infections, and keep paralyzed limbs in functional positions. Massage and passive movement to prevent joint contracture; 3. Surgical treatment; 4. Traditional Chinese medicine, acupuncture, and massage therapy combined with treatment have a certain effect on treatment and recovery. Prevention Hypertensive patients should control their blood pressure under the guidance of a physician, and avoid factors that may induce an increase in blood pressure, such as drastic changes, heavy meals, strenuous activities, forced defecation, and sexual intercourse. Severe posterior headache or neck pain, motor sensory disturbance, dizziness or syncope, nosebleeds, blurred vision, etc. may be signs of cerebral hemorrhage, and you should go to the hospital for examination in time. The dosage and usage of the above drugs must be followed the doctor’s advice. Most of them are caused by cerebral arteriole lesions associated with hypertension that rupture when blood pressure suddenly rises, which is called hypertensive cerebral hemorrhage. What should I do if I have a sudden cerebral hemorrhage? Cerebral hemorrhage is a common disease in middle-aged and elderly people. It is bleeding caused by a sudden increase in blood pressure, causing the capillaries in the brain to rupture. At the site of the bleeding focus, the blood can directly compress the brain tissue, causing cerebral edema around it, and in severe cases, secondary brain displacement, brain herniation, etc. The more typical manifestations of cerebral hemorrhage are as follows: sudden numbness, weakness or paralysis of the limbs on one side. At this time, the patient will often fall unprepared, or the objects in his hand will suddenly drop to the ground; at the same time, the patient will also have a crooked mouth, drooling, and speech. Slurred speech or aphasia, and some may also include headaches, vomiting, blurred vision, impaired consciousness, and incontinence of urine and feces. After a patient has a cerebral hemorrhage, family members should provide emergency first aid. 1． Remain calm and immediately place the patient on their back. Never rush the patient to the hospital to avoid shock on the road. You can tilt the patient's head to one side to prevent sputum and vomitus from being inhaled into the trachea. 2． Quickly loosen the patient's collar and belt to maintain indoor air circulation. Keep warm when it's cold and cool down when it's hot. 3. If the patient is unconscious and snores strongly, it means that the base of his tongue has dropped. You can wrap the patient's tongue with a handkerchief or gauze and gently pull it out. 4. A cold towel can be used to cover the patient's head, because blood vessels shrink when exposed to cold, which can reduce the amount of bleeding. 5. When the patient is incontinent, the patient should be treated on the spot, and the patient's body should not be moved at will to prevent the cerebral hemorrhage from worsening. 6. When the patient's condition is stable and on the way to the hospital, the vehicle should drive as smoothly as possible to reduce bumps and vibrations; at the same time, the patient's head should be slightly elevated to maintain an angle of 20 degrees with the ground, and pay attention to changes in the condition at any time. Cerebral infarction and cerebral hemorrhage require bed rest first, an optimistic and cheerful attitude, full confidence in the recovery of the disease, close cooperation with us, active treatment, and early recovery. Some patients may experience inability to move or weaken one or both hands and feet, or temporary inability to speak, which may have a certain impact on future life. You must have a correct understanding of your disease. As long as you control it with medication early and carry out various A variety of functional exercises and language rehabilitation training (such as counting, talking by looking at pictures, etc.), and perseverance, which has a positive effect on the rehabilitation of paralyzed hands, feet and language functions. Eat high-protein, high-vitamin, low-fat, light, easy-to-digest, nutritious foods, such as fish, soy products, grains, soybeans, etc. Avoid spicy, greasy foods (such as strong tea, coffee, fried foods), and eat more Vegetables and fruits to keep bowel movement smooth. For patients with facial paralysis, semi-liquid foods such as milk paste and porridge can be fed. When eating, the food must be delivered to the healthy side (the area without facial paralysis). The feeding speed should be slow to prevent the patient from choking and coughing, causing suffocation. If the condition is critical and the patient has difficulty swallowing, the doctor will insert a gastric tube and give nasal feeding fluids to ensure nutritional supply. Because the patient's limbs are affected by the disease and are insensitive to hot and cold stimulation, family members are reminded not to use hot water bottles and other heating appliances to help keep warm when the weather is cold. Otherwise, serious consequences such as burns may occur. The patient has difficulty moving his limbs and is incontinent. Pay attention to protecting the skin. Clean the perianal and perineal skin after each defecation and keep it dry. You can apply talcum powder appropriately. Every two hours, the nurse will turn the patient over and pat his back to avoid long-term damage to the skin of the paralyzed limbs. Pressure necrosis occurs and bedsores occur. Within 1 to 2 weeks after the onset of illness, when the condition is basically stable, functional exercises of the affected limb can be carried out as early as possible, three times a day, ranging from 10 to 20 times each time, massage and passive activities can prevent joint adhesions and muscle atrophy. You can increase the number of exercises in the future to help with early recovery. Exercise method: Start with deep breathing and simple active exercises, focusing on stretching exercises of the hands and feet on the side of hemiplegia: shoulder abduction, upper limb extension, and lower limb flexion.

Use pillows and wooden frames to maintain the functional position of the limbs between movements to prevent deformities such as upper limb flexion and foot drop. You can gradually increase sitting, standing and walking exercises to achieve correct walking gait and going up and down stairs. Pay attention to strengthen protection to prevent accidents such as falls. After the upper limb movement function is initially restored, focus on climbing walls, grabbing and placing objects, plate walnuts and other exercises to strengthen self-care skills: eating, grooming, dressing and undressing, etc. As the condition improves further, labor therapy such as writing, knitting, and gardening can be performed. How to communicate with aphasic patients? 1). Use short and clear sentences when speaking, and speak slower than normal. 2). Encourage speaking, do not force it, and use simple and direct questions when asking questions so that the patient can answer "yes" or "no". 3). For those with serious communication problems, you can express your opinions with gestures and facial expressions, and you can also encourage patients to use gestures to communicate. 4). Every time you talk to a patient, give him enough time to think and organize what he says. 5). Talk to him using names and terms he is familiar with. What is cerebral hemorrhage? In medical terms, it means to rule out traumatic cerebral hemorrhage, of which high blood pressure is the most common cause. If someone suddenly has a severe headache, dizziness, nausea, vomiting, difficulty moving their hands and feet, or suddenly cannot speak, is confused, has incontinence of urine and feces, and has elevated blood pressure, a cerebral hemorrhage may occur. Health education 1. Patients need a quiet and comfortable environment, especially within 2 weeks of onset of illness, visits should be minimized, maintain a peaceful and stable mood, and avoid various negative emotional effects. 2. Absolute bed rest for 2 weeks. The head can be gently turned left and right. Excessive moving or raising of the head should be avoided. The limbs can be turned slightly on the bed once every 2 hours. Do not be overly nervous. Defecation and defecation must be done on the bed. Do not get out of bed to defecate on your own to prevent recurrence of bleeding accidents. 3. Some patients will have symptoms of restlessness and restlessness. For such patients, we will take protective measures such as restraint belts and bed rails to prevent unnecessary accidents such as removing the infusion tube or gastric tube on their own, falling from the bed, etc. Some families may not be able to bear it, and we understand their feelings. Once the condition is stable and no longer irritable, we will immediately remove the restraints on the body, but the bed needs constant care, especially for patients with air mattresses, to prevent them from falling into the bed. I hope everyone can cooperate. 4. Headaches of varying degrees may also occur during the course of the disease, such as head swelling and pain, acupuncture-like pain, severe pain, etc. This is the most common symptom. We will provide reasonable treatment. As the condition improves, the headache will gradually disappear, so you don't have to be overly nervous and learn to distract yourself. If you still feel the pain is severe and intolerable during the treatment, please inform us in time so that the doctor can adopt more effective treatment methods. 5. Elderly patients have cardiovascular and cerebrovascular aging and high fragility, and seasonal changes can easily induce diseases. Long-term bed rest is prone to lung infection, and it is difficult to cough up excessive phlegm. Drugs can eliminate phlegm, strengthen turning over and patting on the back, loosen phlegm and cough up, and reduce lung infection. For those who are unable to cough up sputum, take sputum suction measures and hope they can cooperate. 6. If you stay in bed for a long time and the skin is pressed for more than 2 hours, bedsores are likely to occur, so you should turn over more frequently. Massage the affected areas and keep skin clean and dry. The limbs are placed in functional positions to prevent deformity. 7. Diet: Eat nutritious, low-fat, light and soft foods, such as eggs, soy products, etc. Those who have difficulty eating can turn their head to one side, feed slowly, and avoid talking to prevent coughing and suffocation. 8. To keep the stool smooth, you can eat bananas and honey, drink more water, turn over moderately, and massage the abdomen to reduce the occurrence of constipation. If the patient has not had bowel movements for several days or has difficulty defecating, he can use laxatives to induce defecation. It is contraindicated to hold your breath for defecation to prevent another cerebral hemorrhage. 9. During the recovery period, according to the doctor's instructions, raise the head of the bed 10 to 15°, and then gradually raise the head of the bed to a semi-recumbent position according to tolerance and adaptability, ranging from 30 minutes to 1 to 2 hours a day. 10. High blood pressure is a common cause of this disease. Take antihypertensive drugs on time and in a regular amount, and do not increase or decrease the dosage at will to prevent sudden rises and falls in blood pressure, which may aggravate the condition. 11. Regular outpatient follow-up after discharge, monitoring blood pressure, blood lipids, etc., and appropriate physical activities, such as walking, Tai Chi, etc. Diet for patients with cerebral hemorrhage In addition to drug treatment, a reasonable diet also plays an important role in recovery. If the stroke patient's condition has been stabilized but has varying degrees of consciousness disorder or difficulty swallowing, he should adopt a nasogastric feeding diet, in which easily digestible fluid-like diet, such as thick rice soup, soy milk, milk, fresh vegetable juice, fruit juice, etc., should be fed in batches. Pour in, or pour in 1000-2000 ml of mixed milk 5-6 times. The food should not be overheated or cold, preferably 37℃-39℃. The raw materials required for preparing mixed milk are 600 ml of fresh milk, 350 ml of thick rice soup, 2 eggs, 50 g of sugar, 10 g of sesame oil, and 3 g of salt. The preparation method is divided into three steps: (1) Crack the washed eggs, put them into a clean container, add sugar, salt, oil, and stir well with chopsticks; (2) Mix 600 ml of fresh milk and 350 ml of rice soup and boil; (3) Pour the prepared egg mixture into the boiled milk and rice soup, and stir with chopsticks while pouring to form 1000 ml of mixed milk. This 1000 ml mixed milk contains 40 grams of protein, 40 grams of fat, 120 grams of sugar, and 4184 kilojoules (1000 kcal) of calories. If the patient is complicated by diabetes, avoid adding sugar. If the stroke patient is conscious but sometimes chokes and coughs when eating, he should be given a paste diet, which includes steamed egg custard, thick porridge with minced meat and vegetables, noodles with minced meat and vegetables, lotus root starch with milk, fruit puree, or The food is mashed with a masher and given to the patient.

Stroke patients who do not have difficulty swallowing during the recovery period should mainly eat soft and balanced meals that are light, less greasy, and easy to digest. First of all, animal fats, such as lard, butter, butter, etc., and foods with high cholesterol, such as egg yolks, fish roe, animal offal, fatty meats, etc., should be restricted, because the saturated fatty acids contained in these foods can increase blood cholesterol levels. The concentration is significantly increased and promotes arteriosclerosis; vegetable oils, such as soybean oil, camellia oil, sesame oil, peanut oil, etc., can be used because the unsaturated fat contained in them can promote the excretion of cholesterol and convert it into bile acids, thereby reducing blood cholesterol levels and delaying the development of arteriosclerosis. and reduce arteriosclerosis. Secondly, there should be appropriate protein in the diet, and often eat egg whites, lean meats, fish and various beans and soy products to supply the amino acid needed by the body. Generally, drink one cup of milk and one cup of kefir every day. Milk contains milk factors and orotic acid, which can inhibit the synthesis of cholesterol in the body and reduce the levels of blood lipids and cholesterol. The milk skin can be removed when drinking milk. Beans contain stigmasterol, which also promotes cholesterol excretion. Third, eat more fresh vegetables and fruits, because they contain vitamin C, potassium, magnesium, etc. Vitamin C can lower cholesterol, enhance the density of blood vessels, and prevent bleeding. Potassium and magnesium have a protective effect on blood vessels. Fourth, you can eat more iodine-rich foods, such as kelp, seaweed, dried shrimps, etc. Iodine can reduce the deposition of cholesterol on the arterial wall and prevent the occurrence of arteriosclerosis. Fifth, it is appropriate to have less than 6 grams of daily salt. Because salt contains a large amount of sodium ions, excessive intake of sodium ions by the human body can increase blood volume and heart burden, and increase blood viscosity, thereby raising blood pressure. , detrimental to stroke patients. Sixth, avoid foods that excite the nervous system, such as wine, strong tea, coffee and irritating condiments. In addition, eating less chicken soup and broth is beneficial to protecting the cardiovascular and cerebrovascular systems and nervous system, and overeating should be avoided. If you have a stroke patient at home, you can generally choose the following auxiliary dietary prescriptions: 1. 6 grams of black fungus, soaked in water, add to dishes or steamed food. It can lower blood lipids, anti-thrombosis and anti-platelet aggregation. 2. Take 5 celery roots and 10 red dates decoction in water, eat the dates and drink the soup, which can lower blood cholesterol. 3. Eat fresh hawthorn or soak hawthorn in boiling water, add an appropriate amount of honey, and drink it as tea after cooling. If you have a stroke complicated by diabetes, you should not add honey. 4. Eating 10-15 grams of raw garlic or onions can lower blood lipids, enhance fibrin activity and resist vascular sclerosis. 5. Stroke patients take 5-10 ml of vinegar after meals, which can soften blood vessels. Sequelae of cerebral hemorrhage - a secret trick for recovery. After treatment, some of the lives of patients with cerebral hemorrhage have been saved, but the sequelae of hemiplegia remain, especially the patient's hands, which are always like making fists and cannot be opened. There is a trick passed down from our family. By pressing the roots of the patient's fingernails, the hand can be stretched. If the patient is pressed once a day, after seven or eight times of pressing, even if the hand cannot return to its original good level, free stretching is not a problem. The specific method is: the operator uses the thumbnails of both hands to press the nail root of the patient's affected side. The requirement is that it must be pressed onto the nail root and not on the nail flesh. Once the position is found, with a gentle exertion, the patient's fingers will stretch out on their own. The time should not exceed 30 seconds. It would be better if you add thoughts. Both the surgeon and the patient chant "the meridians are unblocked and the cerebral blood vessels are unblocked". The order of pressing is: first press the root of the middle finger and thumb nail (the fingers will stretch out as soon as you exert force), then press the root of the index finger and ring fingernail, and finally press the root of the middle fingernail and the root of the little nail repeatedly, and press back and forth three times. (Sun Hongde, Changling County, Jilin Province) After patients with cerebral hemorrhage pass the acute stage, the following issues should be paid attention to: (l) Psychological care: In the acute stage, family members and patients focus on saving lives, while in the recovery stage, they are often eager to recover their functions. Asked to take care of themselves quickly and even go to work. There are many people who require new drugs and new methods for treatment; some patients are pessimistic, disappointed, and depressed. Therefore, patients should be encouraged to build up the confidence to overcome the disease, to be mentally disabled even if they are physically disabled, and to be strong-willed even if they are physically disabled; they should be realistic about their diseases and functions, and strive to achieve a good prognosis. It is necessary to cooperate well with medical staff and families to defeat the disease together. "As soon as it comes, let's make peace with it." Otherwise, if you rush for a cure, you will easily become impatient, which will be disadvantageous. (2) Pay attention to the rational use of medications: Since patients often suffer from several diseases or multiple symptoms at the same time, the doctor has already prescribed a variety of medications. Relatives, friends or family members should not use many more medications on their own. Excessive and excessive use of drugs may have side effects on the stomach, liver, kidneys or hematopoietic system. Not only will it not speed up recovery, but it may lead to other problems. (3) Prevent recurrence of stroke; preventing recurrence during the recovery period is very meaningful. Because stroke can reoccur suddenly, the more attacks occur, the sequelae of each attack will add up, the prognosis will be worse, and the mortality rate will also increase greatly. In order to prevent recurrence, attention should be paid to stable blood pressure, appropriate food intake, and whether there are any complications in the heart and lungs. (4) Do a good job in family rehabilitation: The recovery period is generally spent at home, and family members should understand how to do a good job in family rehabilitation. Drugs are no longer the main therapy during this period. (5) Pay attention to rehabilitation care: including psychological care and basic care to ensure the patient's basic living needs; provide special care, depending on the specific patient and condition, such as care for nasogastric tubes, urinary catheters, bedsores, etc. (6) Ensure proper nutrition and intake: Because stroke patients are often aphasic, unable to express their wishes correctly, or have choking, coughing, or difficulty swallowing, they are unable to eat and their intake is often insufficient or excessive. Family members should provide adequate Pay attention to. It is necessary to set the recipe, the amount and the time for feeding, and if necessary, feed it through the nasal tube.

(7) Smooth stool: Constipation and excessive force during defecation can induce hemorrhagic brain disease and cerebral embolism. In order to keep the stool smooth and defecate regularly, eat celery, carrots, fruits, etc. appropriately. Medicines can be used when necessary, such as boiling water for diarrhea, Maren Runchang Pills, Guodao, etc.

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