Stroke: master the correct rehabilitation method and actively prevent recurrence

In life, some people have been stunned for most of their lives, and they are afraid of one thing after they are old-stroke. Compared with myocardial infarction and cancer, stroke has a higher disability rate. After a stroke, words stumble, hands and feet do not listen, it is difficult to dress and go to the toilet, and life is better for people who are born to be strong. Therefore, people who pass middle age should learn more about some practical and effective stroke prevention countermeasures, just like grasping the key to the kingdom of freedom for the second half of their lives and preventing problems before they happen.

Cerebral apoplexy is a syndrome of acute onset and neurological deficits caused by blood circulation disorders in the brain, including cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage, etc., with high prevalence, high morbidity, and high mortality And high disability rate.

Prevention of stroke

The prevention of stroke can be divided into primary prevention and secondary prevention. Primary prevention refers to the prevention of risk factors for people who have not yet had a stroke; secondary prevention refers to intervention for patients who have already had a stroke in order to improve symptoms, prevent recurrence, and reduce the rate of death and disability. We must start by developing good living habits, prevent strokes reasonably, and stay away from strokes.

Primary prevention must first delineate people with high risk factors for stroke, including atherosclerosis, hypertension or a history of hypertension, heart disease, especially atrial fibrillation, diabetes, hyperlipidemia, overweight and obesity, stroke or Seven groups with a large family history of heart disease. These seven people must have five words-“Eat, move, and balance.” On the one hand, control your diet, maintain a low-salt, low-fat and low-calorie diet, eat less sugar and sweets, and have balanced nutrition. On the other hand, take appropriate exercise apart from busy work and life. Reduce the time spent on mobile phones and computers, and speed up blood circulation, promote lipid metabolism, and increase the content of high-density lipoprotein cholesterol in the blood through suitable exercise methods, thereby preventing arteriosclerosis and effectively preventing stroke. In addition, quit smoking and limit alcohol. Smoking and drinking with an alcohol content of more than 60 grams per day can significantly increase the risk of stroke. Other aspects mainly include regular health check-ups, standardizing work and rest time, avoiding staying up late and being emotional.

Secondary prevention is for patients who have had a stroke. Hypertension and diabetes are the most risky factors for stroke recurrence, so it is particularly important to actively manage blood pressure and blood sugar. It needs to be emphasized that the prevention of stroke starts from the day when the risk factors are discovered, and the prevention of stroke recurrence should start in the acute phase of the previous cerebral infarction.

Although there are many risk factors for stroke, the etiology and pathogenesis are complex, and effective treatment methods are relatively limited, active primary prevention and secondary prevention of stroke can effectively prevent the occurrence of stroke and reduce the incidence of re-stroke .

Breath-holding is the direct cause of stroke. High-risk groups with cerebrovascular risk factors are usually older people with less exercise and more chronic diseases, who are prone to constipation, especially at the turn of autumn and winter, they are more likely to have dry stool. Forced defecation can lead to increased intra-abdominal pressure and intrathoracic pressure, and poor return of cerebral venous blood, which can easily rupture fragile small blood vessels and cause cerebral hemorrhage.

For the elderly, try not to use squatting toilets at home or when going out, and toilets should be used. Because the intra-abdominal pressure increases when squatting, and holding the breath to defecate, the blood pressure can rise, and cerebrovascular accidents are extremely likely. Sitting can reduce the chance of stroke. In addition, drink more water, eat more fiber-rich foods and fruits to soften stools and prevent constipation. You can also do proper exercise and self-massage your abdomen before getting up in the morning to promote gastrointestinal peristalsis and cultivate good bowel habits.

Rehabilitation of stroke

Due to the improvement of the level of diagnosis and treatment, the mortality rate of stroke is now reduced, but the disability rate is still high. About 80% of the survivors still have varying degrees of dysfunction, that is, sequelae of stroke, which are mainly manifested as paralysis of limbs, aphasia, crooked mouth and eyes, difficulty swallowing, slow thinking, memory loss, irritability and depression. Under normal circumstances, patients with cerebral infarction start rehabilitation exercises when their condition is stable within 2 to 3 days after the onset of the disease, and patients with cerebral hemorrhage start rehabilitation exercises within 1 to 2 weeks after the onset of the disease. As a family member, how should we take care of the patient in order to reduce the sequelae and prevent recurrence?

Chinese medicine rehabilitation

For patients with hemiplegia, use Buyang Huanwu Decoction, which is beneficial to qi, activating blood and dredging collaterals, during the soft paralysis period; in the hard paralysis period, use Siwu Decoction and Tianma Gouteng Decoction which have the effects of nourishing blood, calming the liver, eliminating wind and activating collaterals; For people with speech disorders, the Jieyu Dan, which has the effect of dispelling wind and phlegm, is often used; for those with kidney deficiency, use Zuoguiyin plus or minus; for senile dementia, heche Dazaowan, which is commonly used to benefit the spleen and kidney, nourish the brain, remove blood stasis, and relieve phlegm and resuscitation pill. Traditional Chinese medicine treatment varies from person to person, and it is the best choice to have a TCM doctor with rich clinical experience.

Acupuncture and moxibustion rehabilitation uses acupuncture at certain specific points that can indeed improve the curative effect. For those with paralysis of the lower limbs, soft needles and whitening, for those with incapable shoulder joints, the side is “medium flat and negative”, for those who can’t lift the leg, “leg lift is negative”, and the neck is weak. Needle “shrinks”, etc. In the acupuncture technique, each needle is required to have a feeling of soreness, swelling or directional movement. In some patients with paralysis, acupuncture points should make the affected limb twitch and raise the leg to make the effect obvious and rapid. If the effect is obvious, it can even make paralyzed patients who could not stand up go up and down stairs and enter and leave the house.

Maintain physical position

The finger joints of the paralyzed limb should be stretched and slightly flexed. To this end, a sponge mass can be placed in the patient’s hand; the elbow joint should be slightly flexed, and the upper limb shoulder joint should be slightly abducted to avoid joint adduction, hip extension and knee extension; in order to prevent foot drop, the ankle joint should be slightly dorsiflexed; To prevent external rotation of the lower limbs, place sandbags or other supports on the outside. At the same time, the activities of paralyzed limbs should be strengthened, including body massage, passive activities and sitting, standing, walking exercises, etc., to prevent limb contractures and deformities.

Scientific physical training includes passive movement, active movement and resistance movement of the limbs. Modern rehabilitation medicine sports function training methods should be conducted under the guidance of rehabilitation technicians and according to different conditions.

Dysphagia training practice chewing and swallowing movements. In the incomplete recovery stage, gastric nasal feeding can be used to avoid aspiration pneumonia. In terms of speech therapy, it is clinically divided into mouth shape training and lip and tongue function training (such as pronunciation); in real life, it is encouraged to read more books and newspapers, and watch more audiovisual videos to promote the rehabilitation of the language center.

Avoid bedsores and falling pneumonia due to the movement and sensory disturbances of the paralyzed limbs, and poor local vascular and neurotrophic. If the pressure is long, pressure ulcers or bedsores are prone to occur. Therefore, you should pay attention to changing your body position regularly, usually turning your body once every 2 hours. Maintain personal hygiene, the diet should be nutritious, easy to digest, and must meet the needs of protein, vitamins, inorganic salts and total heat. Keep warm and prevent cold. When turning over, you should tap your back appropriately to encourage sputum to prevent falling accumulation pneumonia.

Doing a good job of rehabilitation psychological care for mental disorders is effective care based on the mental disorders and behavioral abnormalities that have or may appear in stroke patients. Cooperate with anti-anxiety and depression medication when necessary, and the effect is obvious.

The key point is that how to prevent recurrence should first follow the doctor’s advice and insist on taking drugs for a long time. Commonly used drugs such as antiplatelet drugs, antihypertensive drugs, antidiabetic drugs, blood lipids and plaque stabilizing drugs. Secondly, regularly review blood biochemistry, head imaging and vascular examinations to determine the condition, guide medication, and adjust treatment plans. Third, pay attention to daily life adjustments, such as quitting smoking and drinking, avoiding wind and cold, flirting, avoiding fatigue, etc., so that the human body is in a relatively stable internal and external environment, and the risk of stroke recurrence is minimized.

1. Let the Zhongfeng patient maintain a supine position, raise the head, and tilt the head to one side so that vomit etc. will not flow back into the trachea. If you accidentally block your mouth and nose with vomit, you must find a way to clean it so that the respiratory tract should not be blocked.

2. Keep calm and don’t panic, so as not to increase the psychological pressure of the Zhongfeng patient. And hurry up and call the 1 20 emergency number to ask the doctor for help.

3. Try to comfort the mood of stroke patients. Before the doctor diagnoses, you must not let Zhongfeng patients take stroke-related drugs at will.